Surgicalists: Why Aren’t They In Your Hospital?

The Society of Hospital Medicine estimates there are 44,000 practicing hospitalists in the United States. 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. 

Developed nearly 20 years ago, a handful of pioneers in healthcare and business shared a vision. They wanted to help solve the national shortage of orthopedic and general surgeons. The surgicalist model provides a hospital-based career path for surgeons that separates private practice work from acute hospital-based care. And 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 increases hospital quality, efficiency, clinical consistency, and in many cases, downstream revenue.

The Surgicalist Model: A Win-Win
When hospitals work with partners to supply their orthopedic, trauma, or general surgery teams as surgicalist programs, they benefit from increased access to care and service-line growth. Providers enjoy fewer administrative burdens, the elimination of unpredictable on-call duty, and a restored work-life balance.

Dr. Rand Schleusener and Dr. John Campbell are two of the pioneers of the surgicalist model. They met in graduate school where they were challenged to identify and solve a current problem in healthcare. What started as a 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.

Surgicalists are providers who are dedicated to a single hospital. They do not float between 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. 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. ”We were driven to grow the surgicalist concept in an attempt to make surgery a lifestyle job. The ultimate goal is to change the paradigm of how surgery is delivered to patients.” 

Dr. Schleusener adds, “Since the traditional way of delivering call was so frustrating and inefficient, I was confident we were offering a better solution.”  

Building a Unified Team
To bolster hospitals with consistent coverage, surgicalist programs must deliver value to the hospitals as well as to physician partners. Surgicalists are available on-call around the clock during their scheduled shifts. They respond quickly to the emergency department and are solely focused on patient care. 

Communication and team support are essential. Unlike with locum tenens, surgicalists enjoy the benefit of seeing the outcomes of their cases and, in many instances, providers can forge genuine patient relationships. A proven process effectively bridges multidisciplinary pathways of care for patients. With detailed handoffs to cover emergent, acute, and inpatient consult needs, surgicalists are key players in successful coordinated care delivery for hospitals, even in elective cases as needed.

“Surgicalists truly integrate with existing medical staff. They conduct in-person meetings with key medical staff leaders, and they meet with community physicians as genuine partners,” explains Schleusener. “When surgicalist programs are successful, it’s because the patients and team are prioritized above all else.” 

Surgicalists are as dedicated to their assigned hospital as the community providers whom they work alongside, which is a benefit to both the providers and hospitals. 

“Very few clinicians enjoy taking call,” says Dr. Schleusener. “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 doc and the hospital as it provides continuity and predictability for everyone involved.”

A New Way to Access Care
According to data published by the Association of American Medical Colleges, the United States could see an estimated shortage of between 15,800 to 30,200 physicians by 2034, including general and orthopedic surgeons.

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.

According to a paper published by Elsevier made available by the National Library of Medicine, “Increases in surgery trainees will not meet the demand. The continued urbanization of American surgery may push rural hospitals into a vicious financial cycle leading to additional closures of rural hospitals and worsening issues of access.” 

Surgicalist teams 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. 

Many surgicalists request to work in hospitals located near family, favorite recreational activities, or vacation properties. 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. 

A Lifestyle & A Solution
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 will be 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.