The healthcare industry struggles to balance efficiency and quality of patient care, two components that should walk hand in hand. However, challenges in staffing and workforce satisfaction are preventing this. Open Source M.D. (OSMD), co-founded by Dr. David A. Rosen and Dr. William A. Keates, aims to disrupt the space with its new model for hospital staffing; one that prioritizes patient care quality along with physician work satisfaction.
In most hospitals, traditionally, staffing is built around the idea of ‘round-and-go,’ a process that rewards physicians based on the number of patients they see rather than the quality of care they provide. Because of this, physicians feel the pressure to maximize patient numbers, which ultimately results in brief interactions focused solely on the primary issue. Dr. Keates notes that this relative value unit (RVU) approach results in fragmented care, leaving secondary concerns for later and diminishing trust-building opportunities with patients.
Open Source M.D.’s model breaks this volume-drive approach and allows physicians to spend more time with each patient. According to Dr. Rosen, this time investment enhances care quality and leads to more efficient treatment plans. Physicians interact multiple times a day with patients and their families, which improves care outcomes and can further reduce hospital stays.
Another key feature of this company’s model is reducing handoffs, where patients are able to see the same attending physician throughout their stay. This consistency helps in strengthening the doctor-patient relationships and eliminates the confusion that is generally caused due to differing care approaches.
Addressing the surged physician burnout, OSMD also moves away from fragmented, short shifts. This further allows them to oversee patients from admission till their discharge. This improves the patient experience on the one hand, and fosters a sense of purpose among physicians, on the other hand. According to Dr. Keates, this even makes physicians more connected to their patient’s outcomes. “When physicians are given the time to spend with patients multiple times a day and even interact with their families, the quality of care improves extensively,” adds Dr. Rosen.
The extended time with patients allows physicians to delve into complex cases and consult specialists as needed, which is particularly valuable in today’s landscape, where patients often have multiple coexisting conditions. “Patients rarely present with just one issue anymore,” Dr. Rosen points out. “Our model gives physicians the time to consider all aspects of a patient’s condition.”
With access to electronic medical records (EMRs) from multiple sites, physicians have more information at their fingertips. This requires a significant amount of time to review so that the doctor can make informed decisions and adjust treatment plans as needed.
The response from hospitals has been overwhelmingly positive. At one hospital in Oregon, where OSMD’s model was implemented alongside the round-and-go model, the difference was stark. Patient satisfaction was higher, quality of care improved, and hospital metrics saw noticeable improvements.
The integration of OSMD has significantly stabilized the hospitalist medicine group. The extended hours model they follow has directly translated into improved patient satisfaction, more timely discharges, and various other critical quality metrics. By working longer hours, OSMD providers are consistently present on hospital units, fostering a deep familiarity with their patients and maintaining high availability to collaborate with the care team throughout the day.
Physician Jason M. Kuhl, MD, attests to this: This presence is evident during early morning multidisciplinary rounds, as well as during late afternoon planning sessions for next-day discharges—helping improve patient progression through reducing length of stay. Moreover, the providers’ training and attention to accurately capturing the Case Mix Index (CMI) further contribute to our facility’s operational excellence. I continue to be profoundly impressed by the exceptional professionalism, clinical skills, and compassionate care exhibited by the OSMD providers within our facility. Their dedication and expertise are truly remarkable and have been instrumental in achieving our healthcare delivery goals.
“Hospital administrators love our model because they can see the difference in the quality of care and the satisfaction of both patients and staff,” says Dr. Keates. “At the end of the day, we’re trying to prove that you don’t have to choose between efficiency and quality—you can have both.”
