VISTA Staffing Solutions | Locum Tenens

Recent national surveys reveal that hospitalists are the most sought-after providers for locum tenens opportunities in the industry.  Patient’s preferences for on-site and immediate assistance, as well as a personal approach to their specific healthcare needs, has created a growing demand for attentive and available physicians on a consistent basis.  A hospitalist’s ability to manage acute care patients in addition to developing and managing aspects of hospital operations allows facilities to optimize their operations resulting in greater management and care.  Many studies are additionally showing that hospitalists can reduce a patients’ length of stay up to 30% and hospital costs up to 20%.

Historically speaking the hospitalist position was almost unheard of a generation ago.  Today, the average hospital medical group employs 7-8 hospitalists if not more.  Virtually all of our countries leading hospitals in addition to our large managed care programs already have hospitalist departments or voluntary hospital medicine programs in place.  Hospitals and medical groups are also growing their departments in an effort to address and improve the challenges of patient care while enhancing the quality of their services.

Not only is it the fastest growing specialty in modern healthcare, but more and more physicians are pursuing it as a career alternative on a full-time basis.  Many residents are pursuing hospitalist careers upon graduation and many experienced practitioners are returning to inpatient care due to the benefits being provided in this line of work.

Physicians seeking hospitalist positions are usually seeing:

*Higher pay rates

*More diversified schedules

*Average assignments of less than a month at a time

*A greater number of opportunities

*Expanded geographical options

Recently the American Board of Hospital Medicine has started offering certification for this specialty.  More and more educational programs are now incorporating the training necessary for those seeking to pursue this avenue of healthcare.  Experienced physicians are able to obtain privileges based on recent CME’s, procedure logs, practiced skill sets, and comfort in an inpatient setting.

Not only are hospitalists being used within the United States, but they have long existed in Europe and Canada, and are regularly sought after in our International Locums Division.  We are currently staffing hospitalists in the following specialties:

*Internal Medicine

*Family Medicine

*Obstetrics and Gynecology

*Pediatrics

Please call and speak with one of our experienced staff members to determine your qualifications and opportunities available.  We look forward to working with you!

Source: Locums Life, ABPS

In a recent TEDTalk*, Atul Gawande set out his prescription for healing medicine. Gawande is a general and endocrine surgeon at Brigham and Women’s Hospital in Boston, and a staff writer for The New Yorker. His talk included a little history, a little psychology, and, in my opinion, good news for locum tenens physicians.

Gawande explains that the structure of current-day medicine was established in the late 1930s. He quotes Lewis Thomas, author of The Youngest Science, who said that in those pre-penicillin days a hospital patient probably benefited more from the warmth, food, shelter, and caring attention of a nurse than from a doctor’s care. Doctors had a handful of treatments for a handful of recognized conditions and if they didn’t kill you with one of those treatments (i.e., mercury and arsenic to treat syphilis), you would likely get better.

“You could keep what was known in your head,” he says. “You could do it all.”

This reality led to a “craftsman” structure for health care that attracted daring, courageous, independent, self-sufficient practitioners. Autonomy held the highest value.

Fast forward a couple of generations, Gawande says, and healthcare practitioners have access to treatments for tens of thousands of conditions, 4,000 medical and surgical procedures, and 6,000 drugs. We have reached a point where one person can no longer keep it all in his or her head. And it’s a wrong to try. Every provider is now a specialist to some extent. For example, he says, in 1970 a hospitalized patient was cared for by two people, usually a doctor and a nurse. In 2000, a hospitalized patient was care for by the equivalent of 15 clinicians. The complexity can only have increased in the 12 years since, leading Gawande to this conclusion:  “[In medicine,] we have trained, hired and rewarded people to be cowboys, but it’s pit crews that we need.”

What a perfect image. If you think about a pit crew in action you think “communication,” you think “distinct roles,” you think “system.” Gawande’s team at Harvard was asked by the World Health Organization to find a way to reduce deaths during surgery. Instead of simply recommending more training or better technology, the team looked at other high-risk occupations—skyscraper building and aviation. They found systems.

Systems, he explains, have to have these skills:

1. The ability to recognize success and failure through data.
2. The ability to devise solutions.
3. The ability to implement despite deep-seated resistance, which requires a willingness to embrace a different set of values, namely humility, discipline, and teamwork.

While exploring successful systems, they discovered checklists. Not as tools to help the weakest link, but as tools to make the experts better. Tools to provide the best care at the lowest cost.  Reminders of key things that are often forgotten. “Pause points” when it is possible to identify problems before the problems become disasters, “pre-flight” if you will. Their 19-item, two-minute checklist for surgical teams includes the mundane—Was antibiotic administered?—to the intriguing—Has everyone in the OR introduced him or herself at the start of a shift? The checklist has been introduced in eight hospitals from rural Tanzania to the University of Washington in Seattle, and has resulted in a 35% decrease in complications and a 47% drop in death rates.

This shift in thinking creates a tremendous opportunity for locum tenens physicians who, by nature and circumstance, are more pit crew than cowboy. You have the ability to be daring, courageous, and self-sufficient, but you have the insight to know that you will better serve your patients and yourself by collaborating with your new colleagues. Based on decades of conversations with locum tenens doctors before and after assignments, I believe having standard protocols and checklists that get everybody on the same page will help you settle in quicker and ramp up faster. I think it will make your experience in multiple systems across the country and the globe even more highly valued.

Atul Gawande closed his TED Talk by explaining how the same insights have reached cowboys. “I know because I met a cowboy,” he says. “And I asked him what it’s like to herd thousands of cattle over hundreds of miles. ‘Well, ‘ he said, ‘we have cowboys stationed across the range and we communicate electronically constantly. And we have protocols and checklists for how we handle everything from bad weather to emergencies or inoculations for the cattle.”  Well I’ll be danged. Cowboys in pit crews. Who knew?

* TED is a nonprofit organization devoted to Ideas Worth Spreading. It started out (in 1984) as a conference bringing together people from three worlds: Technology, Entertainment, Design. Since then its scope has become ever broader. Along with two annual conferences — the TED Conference in Long Beach, Ca., and Palm Springs, Ca., each spring, and the TEDGlobal conference in Edinburgh, UK each summer — TED includes the award-winning TEDTalks video site, the Open Translation Project and TED Conversations, the inspiring TED Fellows and TEDx programs, and the annual TED Prize.

The importance of making surgery accessible and affordable word wide is gaining much-needed attention in the press, in our medical schools, and in related industry. To my mind, it can’t happen soon enough. Here are three ways you can learn more and/or get involved.

Read!

In the December 28, 2011 issue the Journal of the American Medical Association (JAMA, December 28, 2011—Vol 306, No. 24) Thomas R. McLean, MD, JD, reviewed Global Surgery and Public Health: A New Paradigm, by Catherine deVries and Raymond R. Price, calling it a “fact-packed book (that) will benefit all physicians in the developed world, regardless of their specialty.”

McLean highlights the book’s examination of how making surgery affordable in the developing world can reduce the developed world’s dependency on expensive healthcare technology. He supports the authors’ argument that this benefit is not complex or unique to the surgical industry, but a natural outcome of innovation.

According to the book, McLean continues, developing countries have made strides in overcoming infectious diseases and diseases related to water quality and hygiene. This has allowed more focus on diseases that could be easily treated surgically, such as hernias, cataracts, and vesicovaginal fistulas.

 However, he says deVries and Price are adamant that the solution to implementing a surgical delivery system in the developing world should not be based on a reengineering of expensive models from the developed world, because, “For the 1.6 billion people without electricity, the developed world’s concepts of surgery are impractical.”

The book includes advice on the factors developing countries should consider as they commit economic resources to the creation of a sustainable surgical infrastructure. And it features case studies on how best to partner with private organizations that can help, recognizing that no person or institution has all the tools required to solve this momentous challenge. “But for readers interested in the plight of the less fortunate,” McLean concludes, “Global Surgery and Public Health is a good place to start.”

Learn!

McLean’s review is timely because author Catherine deVries was recently named Director of the Center for Global Surgery at the University of Utah School of Medicine.  In this capacity she is hosting a global surgery conference, Extreme Affordability: Innovative Solutions for Surgical Care, March 22-23, in Salt Lake City, Utah.

Keynote speakers include Clayton Christensen, MBA, Harvard School of Business professor and author of The Innovator’s Dilemma and The Innovator’s Prescription, and Geoffrey Tabin, MD, professor of ophthalmology and visual sciences, director of the Division of International Ophthalmology at the John A. Moran Eye Center at the University of Utah, and founder of The Himalayan Cataract Program. Additional course topics will include The Surgical Ecosystem, BioDesign: Engineering for Extreme Affordability, Surgery for Low Resource Environments, and many more. Find out more at the conference website: http://medicine.utah.edu/globalsurgeryconference.

Volunteer!

Catherine deVries is also founder and president of IVUmed, a non-profit organization I work with as a volunteer surgeon, teacher, and mentor, and as a member of the board of directors. VISTA Staffing has been a long-time supporter of IVUmed, and VISTA’s executive vice president, Katie Hoffman Abby, also serves on our board of directors. IVUmed uses a “surgical education workshop” model to teach medical and surgical techniques in urology to physicians and nurses in developing countries. As I have experienced first-hand in workshops from Kisumu, Kenya to Ulaanbaatar, Mongolia, these workshops are incubators for many of the concepts of extreme affordability and innovation discussed above.  

IVUmed routinely sends volunteers to more than 30 countries including Haiti, India, Honduras, Kenya, Mongolia, Mozambique, Senegal, Nigeria, Vietnam, Zambia, and the West Bank.  Our training programs include pediatric urology, focusing on the treatment of reproductive and urinary tract birth defects; reconstructive urology, for treatment such as hydrocele repair for lymphatic filariasis and circumcision for the prevention of HIV/AIDS; women’s urology, which includes vesicovaginal fistula repair; and much more.  Is the time right for you to help this important movement gain momentum?  For information on volunteer opportunities for urologists, pediatric urologists, endourologists, anesthesiologists, nurses, and non-medical personnel, visit  http://ivumed.org/pages/opportunities_abroad.

Here’s the email copy that we received today from the Medical Board of California. We urge you to read this and take the necessary safety measures.

The Board has been advised that several physicians in the Los Angeles area have been contacted by an individual impersonating an investigator with the Medical Board of California.  The individual asks physicians for their social security number and a credit card number, threatening cancellation of their license.

This individual is NOT associated with the Medical Board of California.  If you have been contacted by anyone representing themselves as a Medical Board Investigator requesting credit card information or social security information, please report this contact to local law enforcement and the Medical Board of California at webmaster@mbc.ca.gov.  Please take the necessary precautions to ensure your social security and credit information is not misused.

You may receive this alert more than once if you are subscribed to multiple Medical Board of California Subscribers’ lists.  We apologize for any inconvenience this may cause.  Thank you.