Small hospitals have fluctuating demand for care and for specialists, like neurology, pulmonology and cardiology. These hospitals also have a more difficult time securing 24/7/365 specialist coverage because of lower revenues that constrain their resources. And, the cost to employ specialists is higher for rural and community hospitals.
Often, specialist want to work at facilities where they can work with larger teams. The team environment enables these physicians to stay up-to-date on changes in their field. To supplement for the shortage of specialists, small and mid-sized hospitals are forced to leverage hospitalists for coverage which is driving an increase in hospitalist salaries as well.
Where do these hospitals turn when they cannot recruit (or afford to recruit) more hospitalists? How do they retain the hospitalists they have? These hospitals turn to telemedicine to reduce the burden of night calls and nocturnists care.
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