Brent Rody M.D.

Capabilities

•  Starting a hospitalist program 

Having started a hospitalist program at Via Christi in Wichita (KS) and re-built a program that was close to being shut down at Spartanburg Regional, I am privileged to have had lots of experience with this growing field of care. A key to the success of any hospitalist program is the relationship of the hospitalists with the ER docs. When dealing with a hospitalist program, a number of critical issues need to be addressed and managed including, but not limited to the following: who admits medical patients, how hospitalists interface with surgical consultants, the financial viability of the relationship, and factoring in the surgical bundle payments; where hospitalists see patients (typically the ER), the time frame of seeing patients in the ER and discharging patients from the floor, and at what point the ER doctor calls the hospitalist with an admission. In addition to dealing with these complex issues, I would work with your finance department to put numbers on what the LOS and early discharge improvements would mean to your bottom line in a DRG-based reimbursement system world.  

• Starting an intensivist program  

I firmly believe that in the right setting, having intensivists manage your ill patients in the ICU’s provides the best possible care for those patients. How this is set up effects the probabilities for success. Do you immediately close the unit to other docs who admit and care for patients in the ICU, do you mandate consults to the intensivists, or do you allow your old model to coexist with the new model? Having a physician interact with your physicians to work through these issues could potentially increase your chance of success with the program markedly. I will also help you consider how to pay for the program, how to determine whether the program is a success both clinically and financially, and how to translate morbidity and mortality and LOS improvements to dollars gained on the facilities' side in a DRG-based reimbursement system. Further, I can consult with you about how physicians integrate this work with their office and/or procedural practices and make them all function—with the hope of having diversity in their lives and practices that will sustain them for years to come.

• OR improvement projects, and negotiation of anesthesia contracts

If it’s time to renegotiate your anesthesia contract, it may be time to look at how the new contract might gain you improvements in your OR. If you’re having difficulties in your OR with efficiencies or relationships between surgeons and OR nursing staff or between surgeons and anesthesiologists, it might be time to examine these relationships. You may also need to consider how to move surgeons to their next case in a more time efficient manner, as well as how to improve the interactions and relationships between these groups. Maybe you want to put block time in: How do you do this fairly, and how do you legislate its use? Maybe the surgeon operates in several different arenas but feels his time at your hospital OR is where he is the least efficient. You certainly can’t afford to lose his or her business, so you have to make sure his or her time is used in the most efficient manner. How do you deploy your anesthesiologists and who “runs the board”? Which of your busy surgeons might benefit from having two rooms side by side, where he or she can literally close one case and move straight to the next patient? What challenging behaviors or practice patterns in your OR need to be addressed and haven’t been?  

• Negotiation of physician contracts  

I negotiated many contracts in my CMO/VPMA and VP of hospital-based physician roles. Consider the benefit of bringing someone in who has negotiated many times, someone who knows the pressures common in both for-profit and not-for-profit scenarios and how mistakes in this area can put your not-for-profit status at jeopardy. My negotiation skills might even be a way to preserve your CMO and keep him or her out of harm’s way. Having a physician who has spent time in administrative council meetings participate in the process also presents the opportunity to put clinical and time parameters that reward excellent physician performance into your contract. Again, I’ve negotiated multiple ER, hospitalists, intensivists (medical and surgical and neurological), anesthesiologists, nurse anesthesthetists, pediatric intensivists, and psychiatrists contracts.    

•  Interim CMO / CMO Mentorship / CMO Recruitment 

I could function for your hospital as an interim CMO or help with either mentorship or with projects to allow your current CMO to focus on other pressing issues. In an interim role I could help you recruit a full-time CMO. I would initially envison part-time to mean one day a week and handling other issues as they came up by phone or e-mail. If you’re looking for an interim to be there for you full-time as an interim, you should look for someone who does that on a full-time basis.  

Previous Work

I was involved in an OR improvement project at Via Christi (Wichita, KS) that addressed issues such as how the head OR nurse was treated, how the staff was treated in the rooms, the OR turnaround times (and addressed exactly what was meant by OR turnaround times), the implementation and legislation of block times and what exactly constituted a surgical emergency, as well as what cases should be done on the weekends and how those decisions affect LOS on the surgical floors, etc.