Hospitalists a "Moving Target," in Great Demand

June 3, 2007
Rebekah McCallister

Internal Medicine World Report, June 2006, Volume 0, Issue 0

Hospitalists are providing care for increasing numbers of hospitalized patients, show results of the new survey conducted by the Society of Hospital Medicine (SHM). On average, hospitalists have >2328 inpatient encounters annually, a 7% increase since 2004.

IMWR

“Hospital medicine is growing so rapidly, we’re trying to define something that’s a moving target. It’s so different from…cardiology or surgery, where the numbers are fairly static,” Laurence Wellikson, MD, FACP, chief executive officer of the SHM, told .

"One of the greatest driving forces in hospital medicine is the demand by primary care doctors that their hospitals get hospitalists." &#8212Laurence Wellikson, MD, FACP

Up to 97% of hospitals surveyed contributed financial support to hospital medicine groups in 2005, at an average annual rate of $50,000 to $60,000 per full-time hospitalist.

“The fact that hospitals are increasingly willing to put their dollars behind their hospital medicine groups demonstrates a growing recognition of the value hospitalists bring to patient care, operations, and quality management,” Dr Wellikson said. One of the ways hospitalists bring value to their institutions is by being more of an “owner” than a “renter,” according to Dr Wellikson. “They’re more involved in the functioning of the hospital. Our doctors are in the hospital ‘24/7.’ If you’re visiting your mother at 6 at night and you want to talk to her doctor, if there’s a hospitalist, then that hospitalist is right there.”

Key findings of the survey include:

• About 75% of hospitalists are trained in general internal medicine, 11% in general pediatrics

• 34% of hospitalists are employed by hospitals or hospital corporations; 20% by academic institutions; 19% by multistate hospitalist-only group or management companies; 14% by multispecialty/primary care medical groups; 12% by local hospital-only groups; and 2% by emergency or critical care physician medical groups.

Hospital medicine is the nation’s fastest growing medical specialty. There are approximately 15,000 hospitalists in the United States today, and this number is expected to reach 30,000 by 2010.

“One of the greatest driving forces in hospital medicine is the demand by primary care doctors that their hospitals get hospitalists. And the reason is that they allow the primary care doctors to focus on their patients who aren’t in the hospital,” Dr Wellikson said.

The ideal relationship between hospitalists and primary care physicians is a partnership where hospitalists “communicate with [primary care physicians] when their patient is in the hospital and work to transition their patient back to them so they understand what happened to the patient in the hospital,” Dr Wellikson said.