When I worked as a hospitalist, I always had my biggest census on the weekends because:
- I couldn't get lexiscans, echos or anything other than emergency ultrasound on the weekends, so I had to hold on to certain cases longer than I would have during the week.
- No social workers, so no rehab transfers even for the minority of local facilities that accepted during the weekends, or discharges for socially complicated patients.
- Last minute, Friday afternoon cases that would normally get an outpatient work-up end up in the ER.
-Friday afternoon ER granny dumps.
-Primary care clinics closed, so couldn't arrange the close follow-up some patients needed to avoid the dreaded re-admission penalty.
There were always more than enough of these to balance out the lack of elective surgery cases during the weekend.
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The only reason I have a bigger census on weekends is because we lose our 8 hour rounder and 2 NP/PAs. If we had steady staff our numbers would be down.