PERSPECTIVE

Reservist Physicians Support Hospitals in Transition

Eva Goodroe

Eva Goodroe

Manager, Strategic Recruiting Programs

Published March 10, 2016

In many ways, it's a wonderful time to be a physician. Whether you're just finishing residency or looking to take your career in a new direction, you'll likely be confronted with a large — even dizzying — array of opportunities.

But sometimes all those choices make committing to a new position more difficult. Maybe you're not sure where you want to live, or what type of hospital is the best fit for your talents. Or maybe you're ready for a taste of adventure after the demands of residency or a long stint in at the same location.

If you're interested in exploring what Vituity has to offer before committing to a location, the Reserves Program may be for you. Reservists complete a variety of short-term assignments while enjoying the benefits of a national physician partnership. In this post, I'll share the history of the Reserves Program, how it works and its benefits for physicians and hospitals.

Growth Demands Change


In 2015, Vituity gained a record number of new contracts. Many of these programs had multiple open physician positions at the time we assumed management.

Such vacancies are pretty typical among contract startups. After all, staffing is a major reason hospitals outsource clinical care or change providers. And it's common for some physicians to leave the department during a contract transition.

Many hospitals and physician groups solve their staffing shortages using locum tenens — temporary physicians hired through an agency. Until recently, locums usually filled in for physicians on vacation, family or professional development leave. But as the physician shortage deepens, they're increasingly filling open positions vacated when doctors leave the organization. The number of facilities using locums has increased dramatically in recent years, jumping from 73 to 90 percent between 2013 and 2014.

While locums can provide a temporary staffing fix, the locum model doesn't really lend itself to launching a successful contract startup. It's important during this crucial stage that the physician group work closely with the partner hospital to meet shared goals. Success in these efforts requires committed leaders who take ownership of the change process — even for the short term.

By contrast, physicians often seek out locum placements in order to practice medicine unencumbered by business or bureaucracy. While this approach might be a good choice for certain individuals, it doesn't take into account the system in which care is delivered. Improving operational efficiency, safety, evidence-based practice and other quality measures requires collaboration with stakeholders across the organization.

Nowhere is this truer than at the beginning of a contract. Startups need committed leaders who take ownership of the improvement process, partner with hospital leadership and build a positive culture.

At Vituity, that's where the Reserves Program comes in.

Partners on the Move


Reservists are Vituity physicians who fill short-term vacancies at our sites across the country. They earn a premium hourly wage during clinical shifts and travel. Vituity also covers the expenses of credentialing, licensure, travel, lodging, billing and malpractice insurance.

Vituity has run a part-time reservist program for several years. Part-timers commit to working five shifts per month for six months. They have some choice in the positions they accept and occasionally work at more than one site. Some are full-time physicians who use the program to supplement their income.

In recent years, demand accelerated to the point where some sites were employing multiple part-time reservists. This created logistical challenges in terms of shift scheduling, travel and recruitment. It was becoming clear that the sites with the greatest need would benefit from a smaller, more committed group of reservists.

To this end, Vituity added a full-time reservist option on Jan. 1, 2016. Full-time reservists commit to the program for a year, during which they are guaranteed 120 hours of work and compensation per month. Candidates must be board eligible or certified in emergency medicine by the ABEM/AOBEM (for emergency physicians) or in internal medicine by the ABIM/AOBIM (for hospitalists).

Vituity matches full-time reservists with open positions based on a number of factors, including active licenses and location. These physicians generally work at only one site at a time.

In return for their greater commitment, full-time reservists become Vituity Partners on their first day of service (as would any of our partners). As such, they enjoy all benefits of ownership, share in the group's profits and have voting privilege. Clinical hours worked as a reservist count toward Partnership advancement.

Life in the Reserves


Serving as a reservist can be an excellent career move for the right candidate. Reservists have the opportunity to "test drive" hospitals and geographic locations before accepting a permanent position. In the same year, a reservist might staff a large urban trauma center, an academic program and a rural community hospital, gaining valuable insights along the way. (You never know. That rural hospital that seemed so isolated on paper might be a fun, tight-knit practice surrounded by gorgeous hiking trails.)

Reserve service provides new Partners with an introduction to Vituity's values and culture. Even as short-term employees, they participate in practice governance and improvement projects. They also learn about the many leadership and educational opportunities available within the Partnership.

To meet its reserve staffing needs, Vituity seeks high-caliber candidates who are interested in building a long-term career within a democratic physician partnership. Full-time reservists should have the flexibility to work nights, weekends and holidays. Reservists typically work within a few flying hours of their homes but should be prepared to go anywhere in the country if the need arises.

While full-time reservists commit to a year and can renew for a second year, recruiters don't recommend making a career out of the program. The reasons for this are practical. The more credentials a physician amasses, the longer the verification process becomes for subsequent positions. Eventually, this can create headaches for employers and even hurt one's job prospects. In addition, it can make it more challenging to get to know the organizational culture if you never settle on a home site.

Who's in?


In its first month, the full-time Reserves Program has attracted physicians both inside and outside the Partnership.

One of the first recruits was a Vituity emergency physician who was moving across the country for family reasons, but wished to remain a Partner. Given the company's growth, he's optimistic there will soon be a Vituity site near his new home. In the meantime, he's finding plenty to do as a reservist.

Another welcome addition was an experienced ED medical director seeking new opportunities. He recently provided invaluable leadership at a contract startup in Kansas. We were especially excited that he could serve as a "cultural ambassador" to some of our newest Partners.

On the other end of the experience spectrum, we're working with an emergency medicine resident who is interested in joining the Reserves this summer. We're excited to welcome him and hope this will prove to be a valuable adventure for him.

To learn more about the Reserves Program, visit go.cep.com/reserves program, or call me (Eva Goodroe) at 510-350-2604.

Partnering to improve patient lives

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