Any clue as to what this specialty is? What they do? Are they going to play a more dominant role in HealthCare in the US?

Thanks for any words of wisdom,
JMPeffer

Any clue as to what this specialty is? What they do? Are they going to play a more dominant role in HealthCare in the US?

Thanks for any words of wisdom,
JMPeffer

Anyone who works exclusively in a hospital. Examples:

Emergency Medicine
Surgery
Anesthesiology
Radiology
Internal Medicine

Anyone who works exclusively in a hospital. Examples:

Emergency Medicine
Surgery
Anesthesiology
Radiology
Internal Medicine

Actually OSU, you may be a little off on that answer. A hospitalist is considered a sub-speciality of Internal Medicine. Basically, they do in-patient medicine, almost exclusively. Check out this thread for more info:

http://forums.studentdoctor.net/showthread.php?t=248159

Take care guys.

Hospital medicine is the discipline concerned with the general medical care of hospitalized patients. Doctors whose primary professional focus is hospital medicine are called hospitalists. Their activities may include patient care, teaching, research, and leadership related to hospital care. Hospital medicine, like emergency medicine, is a specialty organized around a site of care (the hospital), rather than an organ (like cardiology), a disease (like oncology), or a patient’s age (like pediatrics). However, unlike medical specialists in the emergency department or critical care units, most hospitalists help manage patients throughout the continuum of hospital care, often seeing patients in the ER, admitting them to inpatient wards, following them as necessary into the critical care unit, and organizing post-acute care.

About 78 percent of practicing hospitalists are trained in general internal medicine. Another 4 percent are trained in an internal medicine subspecialty, most commonly pulmonology or intensive care medicine. About 3 percent of hospitalists are trained in family practice; about 8 percent are pediatricians and 2 percent are trained as med-peds. The remaining 5 percent of hospitalists are non-physician providers, usually nurse practitioners and physician assistants.

Hospital medicine constitutes a relatively new phenomenon in American medicine. Almost unheard of a generation ago, this type of practice arose from three powerful shifts in medical practice:

* Nearly all states, as well as the national residency accreditation organization (the ACGME), have established limitations on house staff duty hours, the number of hours that interns and residents can work. This effectively reduces by 10-25% the amount of inpatient coverage provided per. Many hospitalists are coming to perform the same tasks formerly performed by residents.
* Most primary care physicians are experiencing a shrinking role in hospital care. Many primary care physicians find they can generate more revenue in the office during the hour or more they would have spent on inpatient rounds, including traveling to and from the hospital. Furthermore, the increasingly specialized care provided in the hospital makes it difficult for primary care physicians to keep abreast of developments. Finally, fewer physicians are establishing solo practices; if one physician of a large group is delegated to make hospital rounds, most of the patients have already lost their familiar contact.
* With strong pressure to decrease inpatient length of stay, coupled with the increasing severity of illness of hospitalized patients required to justify admission, hospitalists are able to provide the increasingly necessary continual on-site availability. It has become significantly more difficult for an office-based physician to effectively direct this.

Hospitalists represent one of the most rapidly growing forms of medical practice in the US. Currently a large proportion of hospitalists are recently-graduated residents, who continue familiar duties for a few years. As residency programs are encouraged to limit inpatient duty hours and provide more outpatient education, this pattern may shift. If this specialty evolves as emergency and intensive care medicine did, it will become a formal speciality with its own residencies and board certification within a decade or two. A few distinct residency and fellowship training programs are currently operating at major universities.

To add to what's been said, as I work quite closely with the hospitalists at St. Vincent's in santa fe. Hospitalists serve two main purposes:

1. Many primary care physicians are not as familiar with the complications a patient may experience in the hospital. For example, acute renal failure, acute respiratory failure, interactions of glucophage and iv contrast, to name a few. Also, the hospitalist is generally more skilled in ACLS, placing central lines, and replacing trach cannulas, that sort of thing. So a primary care doc may hand over patients during their hospital stay to someone who knows the territory a bit better.
2. Many people don't have a primary care physician. Hospitalist take care of those who present to the ED who are not being seen by a primary physician. Many of these people are uninsurred, indigent, homeless, or otherwise the poor of our society. Some hospitalist groups refer these types of patients to community supported family practices and encourage routine healthcare after discharge. Serving the poor coupled with the faster pace of this specialty, and the direction I beleive healthcare is headed, is why I personally am leaning towards becoming a hospitalist.

If I had to do "primary care" this is the only form of it that I would consider. But granted if I wanted to do this kind of practice (the procedures and exercising the knowledge) I would just become a critical care doc.

Many people don't have a primary care physician. Hospitalist take care of those who present to the ED who are not being seen by a primary physician.

A growing number of PCP's are also leaving the care of their hospitalized patients to Hospitalists by choice. They no longer visit the hospital at all, seeing their patients only in the office. So...they also no longer have weekend or night call to split up with their partners. A Hospitalist is always on duty and the nurse doesn't have to call your PCP at home after midnight to ask if she can give another dose of Tylenol. To me, it's a win-win situation for both. The only thing that I worry about sometimes is continuity of care.