About the Hospitalist
Hospitalists are one of the fastest-growing specialties in the United States. A Hospitalist is a primary care physician who limits their practice to the coordination of hospitalized care for patients while in the hospital. The Hospitalist is concerned with the patient’s overall health, not just the condition for which the patient has been admitted to the hospital. A Hospitalist gets the proper specialists involved and also works to properly hand off care to the patient's primary care physician or the next caregiver when the patient leaves the hospital. A key aspect of their role is to communicate conditions, findings, treatments, and results to all physicians involved.
Profile of the Hospitalist
A Hospitalist does not maintain a private practice. He or she is contracted by the hospital. About 95 percent of Hospitalists are trained in internal medicine and the other 5 percent are trained in family practice. They have a broad foundation of medical care knowledge. In 2002 surveys, a Hospitalist's income was comparable to the income of a general internist in private practice.
Duties of a Hospitalist include:
- Maintaining ongoing communication with the primary care physician
- Making daily in-room visits
- Ordering and monitoring necessary tests
- Coordinating care with any other medical specialists the patient might need
- Maintaining communication with family members
- Making appointments with the patient's family physicians and other specialists who will provide follow-up care once the patient leaves the hospital
- Sending complete reports of a patient's hospital stay to the patient's primary care physician
- Organizing follow-up care when a patient has no insurance or primary care physician
According to a Physician Executive article in 2002, statistics on Hospitalists show that:
- Their average age is 40
- Three out of four Hospitalists are male
- Four out of five are educated in internal medicine; the remainder are trained in family practice
- More than half expect to still be a hospitalist in seven years
The Hospitalist Boom
The Hospitalist sub-specialty took off around 1996 when the term was coined in a New England Journal of Medicine article by Dr. Robert Wachter and Dr. Lee Goldman. In 1999 there were about 1,500 practicing Hospitalists. It's estimated that, by the beginning of 2008, there will be 20,000 Hospitalists in the United States, and there will be 30,000 by 2010. Hospitalist will probably be a board-certified specialty within the next few years. The reason for this increase is that Hospitalists enable sub-specialists to concentrate on their specialty and enable the primary care physician to stay in the office where they make more practical use of their time by seeing patients.
The Emergency Room (ER) was a big player in the push to develop a Hospitalist program at Miami Valley Hospital (MVH). The program saves the ER a huge amount of hours trying to find a physician to admit a patient. MVH has fifteen Hospitalists on shift during the day and usually three at night. Also, MVH has a cap on admissions for residents. Once this cap is reached, admissions become the job of the Hospitalist.
The Hospitalist's patient could be anyone brought to the hospital for any reason. Today's patient is sicker than the patient of even five years ago. Insurance is driving this. Pricey co-pays and a lack of affordable insurance have patients waiting until they really need to go to the hospital instead of going as a precaution. Patients are also leaving the hospital faster, since insurance companies are pushing for shorter stays. This means the patient requires more extensive treatment during the shorter time they are in the hospital.