While most Sanford Health physicians live and work in the communities they serve, patients may run into doctors from other parts of the growing organization.
Each year, Sanford Health contracts with external agencies to provide physician coverage when providers are absent, on leave or when a hospital or practice is short-staffed. Known as “locum tenens,” a Latin phrase that means “to hold the place of,” these positions are often difficult and expensive to fill on a temporary basis.
With 1,500 providers and a footprint of more than 250,000 square miles, Sanford Health decided to look internally for a solution that helps keep costs down and gives its doctors a chance to grow. That’s how Solutions by Sanford, an internal locums service, was created in 2017.
Here are three of the doctors who are part of it:
Dr. Benson Hsu
Hsu, M.D., a pediatric critical care specialist in Sioux Falls, South Dakota, had never considered this type of work until he received an email about the need for a physician to cover the pediatric intensive care unit (PICU) at Sanford Medical Center in Bismarck, North Dakota. His question to leadership was, “Can we do this internally?” The response – we can!
“First and foremost, my responsibility is to the Sioux Falls PICU. That’s my job,” said Dr. Hsu. Because his practice is in the hospital and he has periods of time off, his schedule coincided with the needs in Bismarck, and he was able to spend five days in North Dakota. He’s been there twice now, and will go again, if needed and his schedule permits.
Dr. Hsu said there are numerous reasons for doctors to take such temporary assignments. “There are fewer than 15 of us pediatric intensive care docs across the enterprise. Bismarck is trying to grow that service. It only makes sense that we help.
“This is our organization, and we have a responsibility to make it better. When we get out and connect with other people within the Sanford family, our organization is strengthened.”
Seeing patients in North Dakota has improved his relationships and communication with his colleagues across Sanford Health, especially when he receives referrals from Bismarck in Sioux Falls.
Dr. Hsu, who is also involved in leadership for pediatric critical care at a national level, said being exposed to PICUs in different cities and various sized markets allows him to better understand and help develop policy on a national level. “We all trained at academic medical centers. It’s a natural interest of mine to see how other systems practice.”
Dr. Kelly Ming
Ming, M.D., a general surgeon in Watertown, South Dakota, has a regular Monday through Friday schedule of surgeries in Watertown, but she was interested in doing extra work on weekends. When she asked for permission to work with an outside agency, the response from Sanford Health was, “We need coverage, come work with us!”
Sanford Aberdeen Medical Center, just 90 miles from Watertown, was looking for weekend surgery coverage, and the commitment worked out perfectly with her schedule. “My boyfriend works the weekends I’m gone, I don’t have children and I’m willing to travel.“ She now spends one weekend a month in Aberdeen doing surgeries.
“I absolutely enjoy it,” she said. “Of course, there is a bit of a learning curve when you go to a new location, but so far it has been a very smooth transition. The staff is great to work with and very helpful. It is the same electronic medical record system that we use in Watertown, which means I can keep working on Watertown charts if I have downtime in Aberdeen.”
“We’re all part of a team,” said Dr. Ming. “Sanford has a coverage need, and there are doctors out there who want to do this, so it just makes sense to stay within the company.”
Dr. Mian Javaid
Javaid, M.D., a hospitalist in Bismarck, North Dakota, was already working as an independent locums when he was approached about doing internal work for Sanford Health. He specializes in the care of hospitalized patients and works only in the medical center covering nights and weekends. With a fixed schedule of 10 nights per month, Dr. Javaid had the time to travel, and he was interested in working at other facilities around the organization.
He recently traveled to Fargo, North Dakota, for four days to fill in at one of the medical centers and is looking forward to working at other hospitals. For him, it’s a great opportunity for several reasons.
“Obviously, you receive extra income, but an added advantage is you actually learn a lot more when you go outside your own facility. You gain new knowledge, not just medical knowledge, but knowledge about how things operate. You create a network. It really helps in your own practice, and making your own program better,” Javaid said.
“If you’re flexible and like to travel, it’s ideal. Rather than living in a bubble in one facility, you see the world is a much bigger place. It really helps you become a better person and a better physician.”
Darin Musser, director of Solutions by Sanford, said the program not only saves money for the organization, but using Sanford Health-employed physicians to fill the need increases efficiency and quality, since they already know the system and electronic medical record and don’t require extensive training.
Sanford Health will continue to hire some external physicians as needed, but it is expected that the number of its own physicians willing to do locums work will increase, keeping this highly qualified expertise in-house.