I think I need some consulting help, but I’m not sure exactly what I’m looking for. Do I need to have a specific plan in mind before I call you?

Not at all. Just pick up the phone or drop us an e-mail, and we’ll be happy to talk with you informally about your situation and suggest alternatives for structuring a consulting engagement.

How are your fees structured, and how much will it cost us?

Our fees vary based on the scope of work we are engaged to perform, and are competitive with those of other companies providing hospitalist consulting services. We typically propose a single fixed fee for professional services so that you and we both know up front how much the engagement will cost. The only other costs to you will be out-of-pocket expenses associated with travel and document production.

How long does the entire consulting process take, and how far in advance do I need to engage you?

Once you have engaged us we will (usually within just a few days) work with you to establish a mutually convenient date for our site visit. Our calendar varies such that we can sometimes be available to visit within a couple weeks of engaging us, but at times we are booked as far as two or three months out. Once the site visit is scheduled, we will ask you to send us reports and other information, and to begin working with the calendars of those we will need to meet with. We have found these things take most of our clients two to four weeks to complete. We submit our report approximately four weeks following the site visit. So the typical engagement will last two to three months from start to finish.

I don’t need a full consulting engagement, but just want to run something by you. Can I pay you by the hour for your advice?

We don’t usually provide services on an hourly basis. However, if you have an issue and just want to discuss it informally with someone, we’re happy to talk with you once or twice by phone at no charge. If your issue is too complicated for a brief informal phone conversation, we’ll let you know and suggest alternative ways for you to address it.

What we really need is hands-on help with implementing needed changes to our hospitalist practice, in the form of on-site interim program management. Do you provide that?

Yes, we have several members of our team who can provide implementation assistance and/or interim program management for a period of time.  Our goal with interim management is to ensure that positive change occurs in a way and at a pace that the hospitalists and the organization can accept, while also preparing you to successfully operate the hospitalist program on your own after we leave.

Our adult medicine hospitalist program is fine, but I am looking for help with developing or improving a surgical hospitalist, OB hospitalist, pediatric hospitalist, intensivist, or other ``specialty hospitalist`` practice. Can you help?

Yes, this is an area of particular interest for us.  We have experience working with a wide variety of hospital-focused practice specialties (i.e., “specialty hospitalists”) and would be glad to discuss your specific situation and learn how we can help.

We need someone to come assess the clinical quality of care being provided by our hospitalists. Do you do that?

Our consulting services are generally limited to operational and practice management issues.  We do help hospitalist programs develop strategies to contribute more effectively to hospital quality, efficiency and patient experience goals, but don’t assess individual providers’ clinical competency. However, we can often suggest alternative resources to help you obtain services we don’t provide.

I’m concerned about potential conflicts of interest. What other organizations are you associated with?

Nelson Flores Hospital Medicine Consultants is privately owned by John Nelson and Leslie Flores, and has no other owners, investors or subsidiaries.

We don’t accept referral payments, commissions, or any other monetary or non-monetary remuneration from any company or individual.


John Nelson is employed as clinically integrated network medical director and physician advisor for case management at Overlake Hospital Medical Center in Bellevue, WA.  He previously served on the advisory boards of Telmediq, a HIPAA-compliant texting application company, and of IngeniousMed, a software company that provides charge capture and practice management software for hospital medicine practices.  He received a one-time grant of IngeniousMed stock, which he no longer owns.

John Nelson and Leslie Flores are both involved as paid course directors and presenters for a variety of educational programs offered by the Society of Hospital Medicine.  Leslie Flores also serves as an unpaid informal advisor for the Society of Hospital Medicine for practice management issues.

We’ll be happy to let you know about any current or former clients we’ve worked with in your market area, so that you can decide if our work with others poses a potential conflict of interest.