Letter from the Editor

Reconciling hospitals' and hospitalists' goals isn't a simple task, but the creative use of money may make it easier.

No two hospitals are exactly alike in priorities. One may value market share above all; a second may focus on process measures. Hospitalists, too, vary in their goals: Some seek high income, others want a flexible schedule. Reconciling these preferences isn't a simple task, but the creative use of money may make it easier. A growing number of hospitalist employers have devised incentive-based pay structures to selectively reward things like general productivity, night shift work, quality improvement efforts and committee work. Their employees, in turn, have more control over their income and schedule than those working on a strict salary basis. In our cover story, Jan Bowers examines some of the innovative payment structures hospitals have crafted, and the effect they've had on hospitalists. Our Success Story provides a detailed look at one such case—Munson Medical Center, where hospitalists are allowed to set their own work pace and schedule, with their income adjusted accordingly.

Would you enjoy a free lunch, or accept a pen, if it was offered by a pharmaceutical company? If yes, you're not alone. A recent study from the Mount Sinai School of Medicine in New York City found a majority of doctors think industry-physician interactions of this nature are acceptable, and don't feel they are personally influenced by small gifts. Our Q&A with study author Deborah R. Korenstein, ACP Member, explores physician attitudes toward drug and device makers, and how they jibe with those of the public at large.

There is more to a hypertensive emergency than high blood pressure. The real diagnostic key is the involvement of the end organs, which determines whether action is needed in a matter of minutes versus days. Our story will help you distinguish between urgency and emergency, and clue you in on what to do once you make the call. Meanwhile, our Coding Corner column provides guidance on the correct—and somewhat counterintuitive—way to document for hypertensive emergencies and urgency.

Got an idea for a story, or a coding question you would like to see answered? We'd love to hear from you.

Jessica Berthold Editor
ACP Hospitalist