Question: Recently, the Hospital’s CEO and the Emergency Department Nurse Management have been totally consumed by their disappointment with the ED’s key performance metrics. As Emergency Department Medical Director (EDMD) and President of the Emergency Medicine Practice, I want to help achieve the needed improvements and have some ideas about what needs to be done. ...

Question: Our Hospitalists and Emergency Physicians are feuding over the appropriateness of admissions from the ER.  How can we get them to work together better? Answer: As a consultant, I’m frequently asked to offer insight on improving the working relationships between these two practices. The nexus of their interaction is the phone call regarding a ...

In part two of this response, I focus on the systemic issues involved when considering the replacement of a medical director in the emergency department and what to do about them. Part Two: Removing the Obstacles When considering whether to replace the EDMD, look for procedural, financial or organizational impediments to leadership performance. What historical ...

Question: Our Emergency Department Medical Director (EDMD) is one of the original members of our Emergency Medicine Practice. He’s primary care trained like most of our Emergency Physicians and is Emergency Medicine Board Certified but not by the American Board of Emergency Medicine. He’s practiced clinically here for years and has been the EDMD for ...

Question: Recently, the Baltimore Sun published the article “Hospitals Try to Improve Emergency Wait Times” detailing efforts undertaken by hospitals in Maryland and Virginia to reduce waiting times in their emergency departments. The article focused mostly on the activities hospitals used to advertise their improved performance. There were few specifics regarding process improvements themselves. What’s ...

Question: Our Emergency Department Contract is coming up for renewal later this year.  We’re pleased with the physicians that are here providing the coverage, but after several years of waiting the Contract Management Group (CMG) still hasn’t recruited enough full-time doctors to fill all the shifts. They seem more intent on selling their services to ...

Question: Several years ago our local Emergency Medicine Group faced a crisis.  After considerable investigation and evaluation, it was concluded that the best means of retaining the Emergency Physicians was for the Hospital to employ them. All of the doctors became employees at the same time so all of the employment contracts have the same expiration ...

Question: How do we select the right contract management group? Our current provider of emergency physician services is a contract management group (CMG), the third one we’ve had in the past 12 years. The current contract is set expire later this year and the board, medical staff, and senior management team all agree that its ...