What is a hospitalist? In the past, primary care physicians (PCPs) typically followed their patients in both the outpatient and hospital settings. Increasingly, these roles are divided.
Many PCPs no longer manage their patients during hospitalization, instead relying on dedicated “hospitalists” – physicians whose practices consist solely of caring for hospital inpatients. As this trend grows, the number of hospitalists has grown rapidly, doubling in the past 6 years to approximately 25,000 today. This group consists mostly of physicians board-certified in Internal Medicine; a significant minority carry Family Medicine certification. Many have been working as hospitalist physicians since completing training; others have moved to the hospital from office-based practice.
Transitioning to hospitalist care may bring several benefits to patients and physicians. Hospitalists – typically staying in the hospital for the entire workday – are usually more available to help patients, families and nurses address questions and problems which invariably crop up during the day. Due to their more focused practice, they may also be better able to keep up with the increasingly rapid rate of change in hospital medicine. And for outpatient physicians and their patients, allowing hospitalists to manage inpatients prevents the telephone interruptions and schedule disruptions created by PCPs trying to juggle hospital and office responsibilities simultaneously.
Of course, like every new development, the hospitalist movement has its detractors and drawbacks. Patients and physicians alike have been concerned that keeping PCPs out of the management of their patients’ most critical illnesses represents an unattracive discontinuity of care. Evaluating each patient’s prior medical conditions, treatments and preferences may be a challenge for a hospitalist first meeting a patient in an emergency room setting. Likewise, keeping the PCP out of the hospital may make it more difficult to provide appropriate follow-up care for patients upon their return home. The result is a growing need for good communication between PCP and hospitalist. At the same time, many PCPs locally and nationally continue managing their patients throughout their hospital stays. But as hospitalist care continues to gain acceptaince, its growth will continue for years to come.
Dan Litten, MD.
Hospitalist
