Monday, August 25, 2014

A very productive hospitalist

Brad Flansbaum writes the story of a very productive hospitalist.

The physician profiled has 3000 discharges.  Just counting Medicare patients.

Most hospitalists I know run a daily census of 8 to 15 patients.  If this fellow is working at a very high level of 25 (and recall, that would imply no commercial or Medicaid patients) with an average length of stay of five days, that would imply 5 discharges per day.

At that rate, if you worked 365 days per year, you still would not reach even 2000 discharges.  So the 3000 number doesn't add up.

Brad tried his best to get an answer:

In preparing the post, I reached out to him by email and spoke to his practice administrator.  Regrettably, he did not want to comment on the data.  I aspired to learn if he leveraged NP and PAs or other unique resources to assist his group.  

By the way, does CMS do any analysis of this kind of outlier performance?

I'm reminded of the joke about the lawyer who arrives in heaven and is greeted with a spectacular welcoming party.  "What's up?" he asks. "Do you do this for everybody?"

"No," he's told, "but it isn't often we get someone who's lived to be 150."

"But I died at age 85," he says.

"Oh, there must be some mistake," they replied.  "We calculated your age by looking at your hourly billing records."

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