When Dr. Wes Chandler accepted his first hospitalist job, caring exclusively
for patients during their hospital stays, he was handed the on-call pager
on a Saturday morning and left to plunge in.
That experience helped inspire him to start Pacific Hospitalist Associates
in 1997. The group, which employs 44 doctors – 38 of whom are partners
– puts a premium on training, continuing education and rewards for
Pacific Hospitalist doctorswork a week- on, week-off schedule, exclusively
at Hoag Hospital in Newport Beach and Irvine, as well as Hoag Orthopedic
Institute in Irvine.
In a recent interview, Chandler talked about the group he founded.
What do you look for in an employee?
A: We look for somebody who is well trained, comes from a very good institution
that we know, and will likely know someone who has been their mentor and
teacher. A lot of it has to do with personality, someone you can get along
with and someone you think your patients will respond positively to.
How do you train new hires?
A: We have a monthlong orientation for our new physicians. For the first
week they’re literally just getting their passwords and getting
computer access and access to radiology imaging. The second week they
gradually start to see just a few patients, about five a day. The third
week they might see about five to 10, the fourth week, 10 to 15. During
that month, it’s no weekends, no night call. They shadow an experienced
partner. They acclimate gradually, and they become comfortable before
they start working full time.
Q: What types of benefits and compensation do you offer?
A: The physicians generally work a week on and a week off, but they work
12-hour days. They enjoy their time off. In addition to that, they get
four weeks of paid time off and continuing medical education all combined
as one. Then there’s health insurance for physician employees, and
their immediate family can also join in on that plan, pretax. There’s
a 401(k) and a profit sharing plan after one year of employment.
How does profit sharing work?
A: Everybody in the group gets a base salary. On a quarterly basis we have
bonuses. Our bonuses are based upon quality objectives like for reducing
congestive heart failure readmissions or patient satisfaction or report
charting, documenting and coding.
What is your ownership structure?
A: That’s one of the best things about this particular group. We want
our physicians to become owners and partners. It’s a two-year path
to partnership and ownership. About 95 percent of our physicians become
partners and owners.
Why do prospective physicians say they want to work with you?
A: I think for a few reasons. One of them would be of course that Hoag has
a wonderful reputation. We’re one of the few hospital groups actually
owned by the physicians themselves; the ability for partnership and ownership
and the autonomy that comes with that. We decide what our schedule looks
like. If we need more staff at night we can immediately make that adjustment.
Are your employees able to develop relationships with their patients?
A: It’s tough. The average length of stay is only four days. That is
kind of the downside of being a hospitalist. When you pick certain fields
in medicine, there’s certain pros and cons. An ER doctor might only
know his or her patient for four to six hours, and a hospitalist might
only know his or her patient for four days. It can be sort of an intensive
relationship over a short period of time. You’d be surprised by
the end of the few days how grateful someone can be. It’s always
nice to hear thank you.
Since some of your bonuses are tied to patient satisfaction, what do you
think patients want from you?
A: You have to sit down and listen and make good eye contact and be a human
being about the interaction. I could tell you always knock on the door
before you go in; always sit down; call their family; coordinate their
care; after they leave the hospital give them a call and make sure they’re
doing OK. All those things are important. I think the biggest part of
it is just being a caring human being and trying to help them through