ORTHOPEDICS CASE STUDY
Since launching our first Orthopedic Hospitalist Program in 2005, Delphi now holds more than 15 contracts

Situation: Ten private Orthopedists on our client's medical staff were unhappy about constantly being on-call. They approached hospital administration and stated that they no longer wanted to provide any call despite being handsomely compensated with stipends (on top of professional fees collected for services provided). The hospital pushed back on the group to confirm that they were truly willing to let go of all of the call as they realized it would be a huge financial setback to the physicians.  
 
Solution: As a perfect example of Delphi’s flexibility in program set-up, the program was initially designed to be blended, with Delphi providing one Orthopedist to cover weekdays (while the private Orthopedists were in surgery) and then to participate in the 1:11 call rotation. When the program went live Delphi still implemented a blended program. But Delphi recruited the full-time equivalent of 2.5 Orthopedists to provide 25 days of coverage each month while the local physicians covered the remaining days.   

Outcome: Since our program's inception, the local Orthopedists have benefitted from a greatly improved quality of life because of minimal amount of call coverage they have chosen to provide. The hospital's primary benefit became apparent over time. In addition to exceeding Delphi projections for new incremental revenue from the program, the hospital has been truly able to serve the 14 counties that send trauma cases their way. Before Delphi's program the hospital was sending patients away due to phantom call coverage.

OB/GYN (OR LABORIST) CASE STUDY
Since launching our first OB/Gyn Hospitalist Program in 2003, Delphi now holds more than 10 contracts

Situation: A private group of five OB physicians had performed all of the unassigned and indigent deliveries for years. They were paid significant stipends for taking the call. Then one day the group notified the hospital that effective on a specific date later that year they would cease these deliveries, regardless of compensation. 

Solution: With four and a half months notice, Delphi designed and began managing a program that included two local OBs that were interested in being OB Hospitalists. Delphi also recruited one full-time and three part-time OBs to staff the program.  

Outcome: The Delphi group delivers an average of 85 babies per month. They provide coverage to the ED for unassigned gynecology patients on a rotating basis with the private OBs. They respond to urgent and emergent obstetrical situations in Labor and Delivery, assist the private OBs with vaginal and cesarean deliveries when needed and staff a follow-up clinic one-half day per week. In addition, they supervise family practice residents who rotate to the hospital for obstetrical experience.

GENERAL SURGERY (OR SURGICALIST) CASE STUDY
Since launching our first Surgicalist Hospitalist Program in 2005, Delphi now holds 3 contracts

Situation: Lack of affordable medical malpractice created a crisis in a community where surgical coverage at one area hospital was jeopardized. As a result, the hospital’s largest Surgical/Vascular group lost insurance coverage and medical staff privileges. This resulted in a net loss of six surgeons from the surgical call panel. The four remaining surgeons demanded a significant on-call stipend. Hospital administration knew that paying stipends to every surgeon could result in the bankruptcy of the hospital.

Solution: Delphi was identified as the only company with a viable solution to the complex problem. The hospital did not have the months or years it would take for them to recruit new general surgeons to the area. Delphi offered guaranteed 24/7 coverage by boarded Surgeons within a specific timeframe. Delphi staffed the program with two board-certified General and Vascular Surgeons. One of these surgeons was always available for ED/Trauma coverage or to provide surgical services to unassigned patients. Wound care clinic hours were covered and hospital consultations were provided as needed. The Delphi physicians do not have private practices that compete with local physicians. They staff a follow-up clinic in a time-share office owned by the hospital.  

Outcome: In the first year, the Surgicalist program performed 340 cases. The surgical case volume of all local General/Vascular Surgeons increased that year. The hospital was able to bring back one of the General Surgeons who had left and recruit two new General Surgeons to the community by virtue of the fact that there would be no required participation in a call panel.


< Jennifer Kasirsky, MD — Delphi Regional Medical Director and OB Hospitalist