Future of FM Hospitalists

[LeroyJenkinsMD]

Anyone care to speculate? The Society of Hospital Medicine and AAFP released a joint statement saying FM hospitalists should and will continue to be a thing. It also said FM hospitalists will be able to sit for the new board certification exam which is jointly administered by the ABFM and ABIM. This certification will eventually serve as the standard for all hospitalists, regardless of residency training.

We’ve seen joint statements before. We know what happened with OB and emergency medicine. Do you guys think hospital medicine will end of being internal medicine turf, or do you all anticipate hospital medicine becoming a subspecialty and shared turf between FM and IM, similar to sleep, sports, geriatrics, etc?

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[septoplasty]

Its all words, won't know anything until they actually come out with a cert exam, which obviously the ABIM members will have issues with, so might get shut down. As with Ob/EM like you posted, although these positions still exist remotely.

I hope it isn't end of FM hospital medicine, but than again the people who ''decide'' this are college undergrad educated suit types (hospital admin).

 

[deleted87716]

I think the main difference between between hospitalists and OB/EM is the fact that there isn't already a specialty for hospital medicine, unlike the other two fields, so you're not comparing yourself to an established standard. As long as the boards cooperate, I don't see any reason why it wouldn't work out. The people who could get screwed potentially are the outpatient folks who still admit their own patients, but aren't "hospitalists." However, that would still be dependent on individual facility credentialing requirements, which would be no different than it is already.

 

[Keona]

I think it’ll end up a shared subspecialfy and agree that it may end up harming those who admit their own. I think so much of family medicine residency is also hospitalist training and don’t think it’ll go the way of OB and EM.

 

[SXMMD]

I think the main difference between between hospitalists and OB/EM is the fact that there isn't already a specialty for hospital medicine, unlike the other two fields, so you're not comparing yourself to an established standard. As long as the boards cooperate, I don't see any reason why it wouldn't work out. The people who could get screwed potentially are the outpatient folks who still admit their own patients, but aren't "hospitalists." However, that would still be dependent on individual facility credentialing requirements, which would be no different than it is already.

I wanted to be that guy when I grew up and finished residency. Do hospitalists even need their own boards? In what way is this a new specialty vs just the suits putting medicine into silos that are easier for bean counters to manipulate?

 

[deleted87716]

I wanted to be that guy when I grew up and finished residency. Do hospitalists even need their own boards? In what way is this a new specialty vs just the suits putting medicine into silos that are easier for bean counters to manipulate?

I suspect it will end up being more like a fellowship.

 

[MedicineZ0Z]

I suspect it will end up being more like a fellowship.

Why in the world would an IM or FM doc need a fellowship to be a hospitalist? There are very few residencies that *wont* prepare you to be one upon graduation. Exception being open ICU + procedure heavy setting jobs with minimal specialist back up but even the majority of IM guys are not well prepared for those settings.

 

[deleted87716]

Why in the world would an IM or FM doc need a fellowship to be a hospitalist? There are very few residencies that *wont* prepare you to be one upon graduation. Exception being open ICU + procedure heavy setting jobs with minimal specialist back up but even the majority of IM guys are not well prepared for those settings.

Well, IMO, they shouldn’t. But, it’s apparently being discussed nonetheless. I’m not really even sure what they’re driving at. If it’s just an exam, without any additional training, it seems superfluous. I presume they’ll also require board certification in either FM or IM. I suppose they could argue that it’s just to prove competency, but that’s when it starts look more like a money grab.

 

[Atlas Shrugged]

It is absolutely a way to pay attendings less in the guise of more training and will hurt everyone if it goes through. AAFP and ACP should not be endorsing this, but as it is good for the suits it will likely eventually go through.

There is zero reason someone graduating an FM or IM residency would need additional training to take care of general inpatient medicine.

 

[A Nonie Meus]

Why in the world would an IM or FM doc need a fellowship to be a hospitalist? There are very few residencies that *wont* prepare you to be one upon graduation. Exception being open ICU + procedure heavy setting jobs with minimal specialist back up but even the majority of IM guys are not well prepared for those settings.

It’s already happened in peds. Even though peds residents have way more floor experience than outpatient the peds people now require a two year fellowship for hospitalist certification. It’s crazy.


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[LeroyJenkinsMD]

It’s already happened in peds. Even though peds residents have way more floor experience than outpatient the peds people now require a two year fellowship for hospitalist certification. It’s crazy.


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Hopefully FM/IM have learned from this mistake by pediatrics.

 

[SXMMD]

It’s already happened in peds. Even though peds residents have way more floor experience than outpatient the peds people now require a two year fellowship for hospitalist certification. It’s crazy.


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Ridiculous smh

 

[septoplasty]

Hopefully FM/IM have learned from this mistake by pediatrics.

Hah! We wished...

 

[FrustratedFamDoc]

Well, IMO, they shouldn’t. But, it’s apparently being discussed nonetheless. I’m not really even sure what they’re driving at. If it’s just an exam, without any additional training, it seems superfluous. I presume they’ll also require board certification in either FM or IM. I suppose they could argue that it’s just to prove competency, but that’s when it starts look more like a money grab.

I'd like to think my BS-ometer is finely tuned. When decisions/proposals are made that make little sense, there's ALWAYS money as the primary motivating factor.

It seems superfluous because it most certainly is, superfluous and it is all about money. It's trying to solve a problem that never was there, and will most likely spring forth yet another body to be beholden to. New board exam - $$$. Membership dues - $$$. CME requirements - $$$. New fellowship required - BIG $$$ in the form of really cheap labor to hospitals. I'll bet the administrators of this new board probably ain't making minimum wage, either.

In the end, this is yet another money grab in the ever increasing pot that is medicine, with NO intention of actually trying to make things BETTER and/or CHEAPER.

In all liklelihood, this will be readily accepted to the public at large because it'll be branded as better training, more accountable, and whatever else buzzword they'll come up with.

 

[NurWollen]

Hopefully FM/IM have learned from this mistake by pediatrics.

I don't think the powers that be in pediatrics even think of it as a mistake. They're patting themselves on the back. And pediatric hospital medicine has been one of the most competitive matches in the subspecialty match that last couple years, so it doesn't look like they're seeing any lack of interest.

 

[YourMD]

What exactly was the "mistake" between EM and Peds?

I don't think the powers that be in pediatrics even think of it as a mistake. They're patting themselves on the back. And pediatric hospital medicine has been one of the most competitive matches in the subspecialty match that last couple years, so it doesn't look like they're seeing any lack of interest.

 

[NurWollen]

What exactly was the "mistake" between EM and Peds?

Well IDK about EM but peds is making hospital medicine an official subspecialty requiring a 2-year fellowship. This despite the fact that general pediatricians have been doing hospitalist medicine for years and part-time inpatient peds for decades, and despite not clearly showing a need to make it a subspecialty, and despite he fact that peds residents do far more inpatient time than outpatient.

Not necessarily a 'mistake' but many of us aren't convinced that it's the right direction for our specialty.

 

[MedicineZ0Z]

Well IDK about EM but peds is making hospital medicine an official subspecialty requiring a 2-year fellowship. This despite the fact that general pediatricians have been doing hospitalist medicine for years and part-time inpatient peds for decades, and despite not clearly showing a need to make it a subspecialty, and despite he fact that peds residents do far more inpatient time than outpatient.

Not necessarily a 'mistake' but many of us aren't convinced that it's the right direction for our specialty.

That's literally absurd.

 

[YourMD]

Well IDK about EM but peds is making hospital medicine an official subspecialty requiring a 2-year fellowship. This despite the fact that general pediatricians have been doing hospitalist medicine for years and part-time inpatient peds for decades, and despite not clearly showing a need to make it a subspecialty, and despite he fact that peds residents do far more inpatient time than outpatient.

Not necessarily a 'mistake' but many of us aren't convinced that it's the right direction for our specialty.

Absolutely insane! Sounds like a money grab by the powers that be. Hopefully this hospitalist partnership doesn't turn into the same.

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[MedicineZ0Z]

Absolutely insane! Sounds like a money grab by the powers that be. Hopefully this hospitalist partnership doesn't turn into the same.

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Any IM/FM/Peds grad should be ready to be a hospitalist upon graduation. Can't understand how anyone with 2 ounces of common sense can agree to this.

 

[Splenda88]

Any IM/FM/Peds grad should be ready to be a hospitalist upon graduation. Can't understand how anyone with 2 ounces of common sense can agree to this.

I give it 5 years for them to do the same with IM... Hospital medicine has become very lucrative, so people in power are watching.

 

[MedicineZ0Z]

I give it 5 years for them to do the same with IM... Hospital medicine has become very lucrative, so people in power are watching.

Absurd. PGY2s and even some interns by late spring are well ready for most things in-patient. You're like a secretary who knows how to treat CHF and COPD, that's why we even have (lol) midlevels doing it. What could you possibly need a fellowship for??

Some community/rural hospitals in states with less physicians require hospitalists to do a lot. Tubing a patient on the floor? Chest tube in the ICU? Running the vent? Every central line? You're in for all of that. But that's why it's important to get good training during residency.