Hospital nocturnists grow in number, importance

doctor

More hospitals hire experienced physicians to work overnight shifts, hours traditionally manned by residents and nurses.

In 2014, a survey by the Society of Hospital Medicine revealed that 81 percent of adult hospitalist groups had at least one physician who worked overnight shifts, compared with 55 percent in 2012, The Boston Globe reports.

The benefits, according to the article, is that the hospitals have an alert physician available in case of emergency, instead of waking up a doctor to address an issue.

These “nocturnists” also make younger residents feel more comfortable on overnight shifts, as they provide experienced oversight. Otherwise, it may be hard for residents to determine when a patient’s condition requires a late night call to an attending physician, according to the article, and on-call doctors may not come into the hospital in a situation that may warrant it. An on-site nocturnist makes that communication easier.

Sarah Henry, M.D., a nocturnist at Boston Children’s Hospital, told The Globe that her role doesn’t usually call for a dramatic, life-saving decision, but she can be a needed safety check to improve care and patient satisfaction. “When you have a big complicated issue, it’s better to have someone who can navigate it and think about whether there is a better option,” she said.

The major drawback to having experienced doctors on-site during the overnight shift is cost, according to the article. A physician makes more than a trainee, and recruiting an experienced doctor to work overnight may require additional financial incentives. Massachusetts General Hospital, for instance, doesn’t often hire physicians solely as nocturnists, but offers raises and additional time off for doctors who agree to work night shifts, according to The Globe.

Furthermore, many advocate the use of residents on overnight shifts. The practice allows residents to take the lead on night shifts and offers them more autonomy and valuable experience before they practice on their own, according to The Globe. In addition, having a hospitalist on-site for an overnight shift may not improve care compared to what residents already offered, FierceHealthcare previously reported.

- read The Boston Globe article

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