Clinical Component

Navigating the Clinical Component

The role is adult inpatient medicine in a shift-based model with double physician coverage during the day and 24/7 advanced practice provider support. Acuity is manageable for a community hospital, admissions are steady but not high volume, and a broad in-house specialist group is available for consults. Hospitalists admit and manage their own patients and use subspecialists as cases require.

Clinical Snapshot

Detail Summary
Patient Population Adult inpatient medicine
Average Daily Census ~18 patients
EMR Epic
ICU Open ICU, hospitalists admit directly
Procedures Occasional; central and arterial lines, thoracentesis
APP Support 24/7
Call None; shift-based coverage

Patient Population and Acuity

Hospitalists manage adult patients across the medical and surgical floors. As a community hospital rather than a tertiary center, admission volume stays moderate and the case mix is typical for the region. Complex cases are stabilized and referred out when needed: complex pediatric patients to Billings, and pediatric cardiac and neurological cases to Denver Children's.

Coverage Model

Hospitalists do not take traditional call. Coverage runs on shifts, with two physicians providing double coverage during the day and one physician covering nights. Every physician covers some nights during the month; there is no dedicated nocturnist.

Shift Coverage
Morning admissions One physician, 7:00 a.m. to 1:00 p.m.
Afternoon admissions One physician, 1:00 p.m. to 7:00 p.m.
Night One physician, from home within 30 minutes

Census and Admissions

Metric Value
Average daily census ~18 patients (about 12 plus 4 to 6 admissions)
Typical range 10 to 28
Daytime admissions 4 to 6 per day
Night admissions 2 to 5

Admissions are not capped. Volume stays manageable because the hospital is not a tertiary referral center. Hospitalists admit their own patients and call in surgeons or subspecialists when a case requires it. Hospitalists also help run codes.

Procedures

Procedures are occasional rather than a daily expectation. Physicians comfortable performing them are welcomed, but they are not required.

  • Central line placement
  • Arterial line placement
  • Thoracentesis
  • Interventional Radiology assists with PICC line placement

APP Support

The team includes 24/7 advanced practice provider coverage. How APPs are used is set at the discretion of the physicians, which allows each hospitalist to structure support around their own workflow.

Subspecialty and Consult Support

A broad specialist group practices on site, which keeps most consults local.

  • Interventional cardiology (2 physicians; full interventional services short of CABG)
  • Interventional radiology (2 physicians)
  • Large orthopedic group, including spine surgery
  • General surgery (4 physicians; also performs GI endoscopy)
  • ENT, urology, neurology, rheumatology, and pathology
  • New bariatric program and a tele-stroke program

Some services are covered through referral or telemedicine rather than in-house staff:

  • Pulmonology is not on site
  • Gastroenterology scopes are handled by the general surgeons
  • Infectious Disease is contracted through telemedicine out of Casper

Teaching and Research

Teaching is a minimal and optional part of the role. The hospital participates in the WWAMI medical student program, which spreads roughly 300 students across the northwest United States; few rotate through Sheridan. There is no research or clinical trial activity.

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