I know a few physicians who thrive when they work at night, who actually request the night shift and build their careers around it, but they are few and far between. Some time ago, a Today’s Hospitalist article profiled five physicians who prefer that life. Despite their enthusiasm for it, a few acknowledged that it’s probably not wise to do after 40.
How to provide quality night coverage in this scenario? It’s a question that has grown more urgent as the physician shortage escalates. Rural hospitals hit hardest by the shortage face the biggest struggle, but everyone feels the pain of it—physicians, hospitals, and patients alike.
Telemedicine: A solution that really works
With the advent of telemedicine, there is a solution today that really works. I am National Director of Eagle’s telemedicine program, and I see the positive results every day.
It can be overwhelming for a hospitalist to round all day and go home, only to return in the middle of the night to admit a patient. Our telenocturnist program allows these hospitalists the break they need to come back fresh in the morning. At the same time, their patients are continuing to receive excellent physical care through the wonders of telemedicine, where physicians off-site have two-way communication via videoconferencing technology with patients, NPs, PAs, and nursing staff. Hospitals tell us that we are instrumental in helping to maintain a normal work schedule and avoiding burnout.
A logical solution for rural hospitals
For rural hospitals, telenocturnist care is ideal. (See a related blog on how telemedicine is helping many rural hospitals survive.) You often have locum physicians coming through that don’t know the system well, only covering a few nights and then leaving for a new assignment. With our telenocturnist program, hospitals are guaranteed consistent coverage every night.
How does onsite staff respond? Not a problem. Because our telemedicine physicians work in small “pods” assigned to particular hospitals and geographies, clinical staff at the hospitals learn to trust them and develop a good working rapport. The physicians are responsible for all the admissions and consults, rapid responses, and code blues.
Telecross-coverage for larger hospitals
Recently, we have seen another area of night coverage for which telemedicine is a good fit. In mid-size and large metropolitan hospitals, where stress and burnout can run rampant, Eagle telenocturnists can handle cross-coverage calls on the floor, so ED docs and nocturnists can focus on treating and admitting new patients.
Some hospitals make physicians available by telephone to handle cross-coverage, but face-to-face visits with patients via videoconferencing technology are much more effective. And when cross-coverage demands are light, Eagle telehospitalists can help nocturnists admit patients, and provide “surge protection” during peak times.
One of the exciting things about my job with Eagle is seeing new applications for our telemedicine program, like our telecross-coverage service. It has expanded our night coverage services into a whole new area, and the response from the market has been terrific. I’m not surprised by the innovation, however, and I’m sure there will be many more in the future. After all, when the telephone was invented, who knew we’d be using it one day to stream movies or guide us to a new restaurant?