How does the surgicalist model solve the on-call dilemma?

The Society of Hospital Medicine estimates there are 44,000 practicing hospitalists in the U.S. The hospitalist model of care is widely understood and utilized. Although similar, the surgicalist model of care is lesser known, despite its many benefits for hospitals and clinicians alike. It might be one of the best-kept secrets in hospital management today.

For hospitals, the surgicalist model provides the ability to serve patients with access to emergent and acute surgical care — even in difficult-to-recruit markets. The surgicalist model offers staffing predictability, optimizes patient care, and in many cases, improves financial performance. At the same time, providers enjoy fewer administrative burdens, the elimination of unpredictable on-call duty, and a restored work-life balance.

Developed nearly 20 years ago, a handful of innovators in healthcare and business shared a vision: they wanted to help solve the national shortage of orthopedic and general surgeons. Dr. Rand Schleusener and Dr. John Campbell are two of the visionaries behind the surgicalist model. What started as a grad school thesis, eventually evolved to the surgicalist model and ultimately, Synergy Health Partners. While Drs. Schleusener and Campbell were not the only early proponents of this solution, they are credited with marketing the term “surgicalists” nationally.

When hospitals implement surgicalist programs to supply their orthopedic, trauma, or general surgery teams, they benefit from increased access to care and service-line growth. Surgicalists are dedicated to a single hospital and don’t float among facilities like locum tenens. They serve on committees, engage with the community at large and work side-by-side with hospital employees as a true team member. Surgicalists are assigned regular shifts and are paid on a per diem basis as independent contractors.

“Little did we know back when we were in grad school that our idea could support an entire industry,” admits Dr. Campbell. “The ultimate goal is to change the paradigm of how surgery is delivered to patients.”

Data published by the Association of American Medical Colleges indicates that the U.S. could see an estimated shortage of between 15,800 to 30,200 physicians by 2034, including general and orthopedic surgeons. This may be particularly troublesome for rural hospitals. As the number of surgery trainees does not meet the future demand, coupled with the urbanization of American surgery, rural hospitals could experience an adverse financial cycle leading to closures and worsening issues of access.

The impact of a successful surgicalist program on a hospital community can be enormous. Some hospitals simply can’t provide much-needed service lines without a surgicalist program. In many cases, hospitals outsource surgicalist teams to build new service lines or to gain advanced trauma center designations. The right partner will work with each hospital to assess their needs and opportunities and build a surgicalist team to best suit each unique business strategy.

Surgicalist programs deliver value to physician partners as well. Unlike locum tenens, surgicalists enjoy the benefit of seeing the outcomes of their cases. Surgicalists are as dedicated to their assigned hospital as the community providers, which is a benefit to both the providers and hospitals. “Surgicalists are truly integrated; they conduct in-person meetings with key medical staff leaders, and they meet with community physicians as genuine partners,” explains Schleusener. “Surgicalist programs are successful, because the patients and team are prioritized above all else.”

Dr. Schleusener adds, “Very few clinicians enjoy taking call. As a surgicalist, you know in advance when you need to be available. You can schedule your life around dedicated shifts at a single hospital. And when you’re off work, you’re truly off. This is good for the physician and the hospital as it provides continuity and predictability for everyone involved.”

Surgicalist providers do not need to relocate or uproot their families to serve a remote hospital. Many surgicalists work shifts consisting of seven to 11 days per month and therefore fly to their assigned hospital as scheduled. This enables the program partner the unique ability to attract exceptional surgeons to work in remote locations. This results in a mutually beneficial staffing outcome for the hospital, the clinician, and the patients who are presented with increased access to care as a result.

The surgicalist model is gaining traction for big reasons. As the trend of partnering with clinical management services firms continues to grow in parity with the forecasted provider shortage, surgicalists are growing in demand. When surgeons are focused on patient care and enjoy an improved work-life balance, healthcare in general benefits. What began as a graduate school homework assignment just might be the solution needed to support rural and urban hospitals across the country.

Learn more about the Surgicalist Staffing Model.