Letter from the Editor

Once you've recruited a few great hospitalists to your program, you might be tempted to think you've solved your staffing woes. But recruitment is only half the battle. You also need to worry about that other “R” word: retention.


Once you've recruited a few great hospitalists to your program, you might be tempted to think you've solved your staffing woes. But recruitment is only half the battle. You also need to worry about that other “R” word: retention. Recent data from the Society of Hospital Medicine point to a median annual turnover rate in U.S. hospitalist programs of approximately 9%, while other estimates are more than twice that. What's a program director to do? As our cover story shows, competitive salaries help but aren't always the answer. Read it for advice on holding on to your hospitalist hires.

It's not always easy to add another piece to the clinical encounter in the middle of a busy day, but research shows that one critical aspect is often overlooked: discussions about code status. According to a 2008 study in the Journal of Hospital Medicine of six university-based hospitals, only 10% of patients had documented code discussions 24 hours after admission. Discussions about end-of-life and palliative care can be difficult, but learning a patient's code status can help you provide appropriate care. Our story in this issue offers tips on how to broach this complicated subject.

With the economy in trouble, more hospital administrators are asking hospitalist groups to prove their value to their institutions. Traditional measures like reducing length of stay and cost per stay are still important, but hospitals are also looking at other areas, such as whether hospitalists are helping to attract more primary care doctors. It's best to keep track of your data now so that you know the answers to administrators' questions ahead of time, experts say. And don't forget that your group provides value in other, less quantifiable areas, such as committee participation and improved nursing satisfaction. Our story offers more ideas on how to respond when administrators want to know what you've done for them lately.

Also in this issue, we debut a new column by editorial advisory board member Lisa Kirkland, FACP. “Technology Traps” will appear monthly and will examine the limitations of some of the high-tech devices used in everyday practice. This month, Dr. Kirkland discusses the potential pitfalls of relying on automated noninvasive blood pressure monitoring. Find out why you can't always trust the machine.

If you have other ideas for column topics, we'd love to hear about them. Email us.

Sincerely,
Jennifer Kearney-Strouse
Executive Editor, ACP Hospitalist