Address Hospitalist Autonomy to Improve Retention

Physician Compensation & Recruitment , March 6, 2008
Working as employees, hospitalists give up a certain amount of control and autonomy compared with physicians in private practice, which can cause unrest if not addressed. It can be distressing for physicians to feel responsible for producing results to which they are deeply committed while lacking the capacity to deliver on that mandate.

Address four areas of autonomy/control to improve hospitalist retention:

Task control. Hospitalists generally lack control of many daily tasks due to a variety of external factors, such as the shortage of specialists, limited hospital resources (e.g., lab, radiology, etc.), daily interruptions, and excessive workloads.

Organizational control. As employees, hospitalists have less control over operations and business decisions than they would in private practice. Representation on key hospital and medical staff committees gives hospitalists a voice at the table and can go a long way toward easing concerns about organizational control.

Physical environment control. Give hospitalists adequate office space and freedom in the design of workstations, hospital rooms, etc.

Resource control. The hospitalist medical director should have a major influence over program budget, and rank-and-file hospitalists should have representation on a compensation committee and the ability to influence elements of their own incentive plan.

This story was adapted from one that first appeared in the March edition of Physician Compensation & Recruitment, a monthly newsletter by HCPro Inc. For information on all of HCPro's products, visit




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