My experience from Hospitalist to SNFist
by John Hurwitz, DO
In My Own Words

Two years ago I made the transition from full time Hospitalist to full time SNFist.  I am quite satisfied with this change, for a number of reasons. It is very clear that the changes in the delivery of healthcare will make the post-acute space one of the most highlighted and focused places for improvement in the care continuum.

One of the key needs is to be able to efficiently manage a “sicker” and more “acute” subset of patients at post-acute facilities and a hospitalist’s skill set is well suited to manage these patients.  Hospitalists also fill a niche in the hospital where they are quite involved in utilization management and quality metric success.  These same skills are tremendously beneficial to SNFs as well as to hospitals that will only want to partner with SNFs that are able to succeed in meeting quality measures.  Physicians with a focused SNF practice can provide a consistent presence and integrate into the fabric of the interprofessional team and be a key member and leader to improve the delivery of care.  I don’t believe you can achieve the same level of effectiveness without a focused practice at a very limited number of facilities.  I don’t believe the model of hospitalists simply rotating through the facilities as part of a larger combined hospitalist/SNF practice has the desired impact.

From a personal and professional standpoint, I find my practice very fulfilling.  I enjoy working with a small and effective group of professionals who appreciate my presence.  I was in an office-based private practice earlier in my career, and I find my current SNF-based practice to offer the best of both worlds:  Acuity, continuity and meaningful influence.   I measure job satisfaction by a quotient I developed:

Job satisfaction = autonomy + influence – (stress + aggravation) / income.

In my career, it’s never been higher.