What types of comanagement make hospitalists nervous?

WHAT AREAS OF COMANAGEMENT make hospitalists nervous? In our annual survey, we gave hospitalists a list of 10 types of comanagement services and asked them to rank how comfortable—or nervous—each made them. Here’s a look at what we found.

What specialties are hospitalists most comfortable comanaging?

When it comes to comanagement lines that hospitalists say they are “very comfortable” providing, more than half mentioned these three specialties: cardiology (63.4%), nephrology (61.1%) and orthopedics (55.4%).

Combine “very comfortable” with “comfortable” in the rankings and the same three specialties come in at over 90%. Among responding hospitalists, 97.3% reported being either comfortable or very comfortable comanaging nephrology patients, 95.6% cited cardiology and 93.7% named orthopedics.

What kinds of comanagement make hospitalists most nervous?

As for comanagement agreements that make hospitalists skittish, the one they claims they are the most uncomfortable with was also the one with which they had the least experience: pediatric medicine. Eighty-four percent of hospitalists don’t work with pediatric patients, which may explain why 38.5% said comanaging these patients makes them nervous.

Comanaging patients from three other specialties made more than 20% of hospitalists uncomfortable: psychiatric mental health/behavioral health (24.9%), substance use disorder (20.9%) and neurology/neurosurgery (20.6%).

Here’s a list of all 10 areas of comanagement we asked about and how hospitalists ranked each:

• Cardiology

Do not comanage: 2.0%

Comfortable: 95.6%

Nervous: 4.4%

• General surgery

Do not comanage: 2.1%

Comfortable: 88.0%

Nervous: 12%

• Nephrology

Do not comanage: 2.1%

Comfortable: 97.3%

Nervous: 2.7%

• Neurology/neurosurgery

Do not comanage: 3.5%

Comfortable: 79.4%

Nervous: 20.6%

• Oncology

Do not comanage: 2.5%

Comfortable: 82.1%

Nervous: 17.9%

• Orthopedics

Do not comanage: 1.8%

Comfortable: 93.7%

Nervous: 6.3%

• Pediatric medicine

Do not comanage: 83.8%

Comfortable: 61.5%

Nervous: 38.5%

• Psychiatric mental health/behavioral health

Do not comanage: 11.3%

Comfortable: 75.1%

Nervous: 24.9%

• Pulmonary/critical care

Do not comanage: 8.0%

Comfortable: 89.5%

Nervous: 10.5%

• Substance use disorder

Do not comanage: 9.7%

Comfortable: 79.1%

Nervous: 20.9%

For more survey data, including how physician compensation is affected by bonuses, experience, shift work and location, check out our overview on hospitalist pay.