Samaritan Hospital in Troy contracts for 2 "surgicalists" with a weeklong schedule

By ALAN WECHSLER, Business writer

TROY -- It's not a schedule most workers -- much less doctors -- would chose: 168 hours on, 168 hours off.

But for the two new newest surgeons at Samaritan Hospital, their weeklong schedule means freedom: from paperwork, from malpractice worries and from the hassles of running their own office.

The two are being hired as Surgicalists, a new term coined from the more common title Surgical Hospitalist. Both mean the same thing: doctors hired by hospitals to treat patients full time, replacing local physicians who work at the hospital on an "on-call" basis.

"We're all very optimistic," said Dr. Howard Floch, one of the two new surgeons, who is now based in North Carolina. "We think this is going to be great."

The doctors, who begin work on Tuesday, will actually be employees of Delphi Healthcare Partners Inc. of Morrisville, N.C. Samaritan signed a three-year contract with Delphi for an undisclosed sum.

At Samaritan, like many hospitals, some doctors were starting to balk at the idea of being on-call nights and weekends. Hospitals commonly require doctors with hospital privileges to serve on-call regularly.

But Samaritan was losing doctors, and risked not having enough coverage, said Dr. Dan Kopp, medical director at Northeast Health, the Troy-based regional health care network that includes Samaritan.

The Surgicalists will handle emergency surgeries and such relatively common procedures as appendectomies and gall bladder removal. They can intubate patients and do other procedures that otherwise might pull a sleeping doctor out of bed.

While the shifts are long, Surgicalists are expected to have plenty of time to rest between jobs during their weeklong shifts. They will have apartments near the hospital and, at slow times, will be required only to carry a pager and cellphone and be a few minutes from the hospital.

"The idea of this program is a doctor can come into this situation, have no overhead to worry about, and just practice what he is trained to do," Kopp said.

Kopp described the contract cost as "significant." "The reason for putting this into place is we were running out of surgeons," he said.

At Delphi, President David Joyce has banked his future on the need for hospitals around the country to contract for surgeons. The 4-year-old company has placed obstetricians in several hospitals in California -- where they are called OB Hospitalists -- and put two Surgicalists in a hospital in West Virginia.

"Increasingly, physicians of all specialties don't like taking emergency department calls for unassigned or indigent patients," he said. "We're providing a group of physicians who will exclusively take those calls."

At Thomas Memorial Hospital in South Charleston, W.Va., Dr. Richard Fogle has been a surgicalist with Delphi for about a year.

"The happiest I was surgically was when I just worked in a hospital," he said. "When this came across, we thought it has to be too good to be true."

The Surgicalist concept is something that hospitals are going to be seeing more and more of, said Dr. Paul Collicott, director of member services at the American College of Surgeons, a trade group in Chicago.

"It appears to be a developing niche for general surgery, filling a need that obviously exists because a lot of general surgeons are limiting their practice," he said.

But the concept of a dedicated surgeon working for a hospital is not new, said Dr. Ferdinand Venditti, president of faculty practice at Albany Medical College. At the college, professors work a 24-hour surgical shift at the hospital as part of their duty.

"Our attending physicians actually sleep in the hospital so they're available for any number of things that might happen," he said.

But with a growing shortage of doctors, the Surgicalist concept could become more popular, he said. "I think in the next couple of years you are going to see the effects of the shortage more and more," Venditti said.