More hospitals are using 'substitute physicians' — are they safe?

More hospitals are hiring outside physicians to fill in for staff physicians who are sick, on vacation or attending conferences. Initial research from Boston-based Harvard Medical School suggests this practice is safe for patients.

For the study, which was published Dec. 5 in JAMA, researchers analyzed data on 1.8 million Medicare hospital admissions from 2009 to 2014.

Here are four study findings.

1. Substitute physicians managed about 40,000 of the 1.8 million hospital admissions included in the study.

2. One in 10 physicians was replaced by a substitute physician during the study period.

3. Patients exhibited no significant changes in 30-day mortality rates when treated by a substitute physician versus a regular hospital staffer.

4. Patients treated by a substitute physician had higher Medicare Part B costs and longer lengths of stay, but lower 30-day readmission rates.

"Our findings so far are reassuring, but some of the trends we found demand that we look more closely at how the system works in a more granular way," said senior author Anupam Jena, MD, PhD, the Ruth L. Newhouse associate professor of healthcare policy at Harvard Medical School. 


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