What is a Hospitalist?

[Nasrudin]

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Just curious what the difference is between an Internal Medicine attending and a Hospitalist--which as best I can understand it is a relatively new concept about an ermerging specialty within Internal Medicine.

I've heard a little about this field, but i just don't understand how its different from any other internal medicine doctors working in a hospital?


Thanks.

 

[Hernandez]

Hospitalists work strictly in the hospital and have no outpt clinic. They tend to work from groups or hospitals with set shift work based hours.

 

[BMW19]

Can anyone elaborate on this newfound specialty of IM? Salary? Respect? Sounds like a good deal. NO dealing with insurance companies. Shift work. I am sure you can work your way into CCM somehow without a fellowship being wholey hospital based? Any opinions?

BMW-

Hospitalists work strictly in the hospital and have no outpt clinic. They tend to work from groups or hospitals with set shift work based hours.

 

[Hernandez]

Salary?

Highly variable by geographical region and how you're employed. The NEJM classifieds seem to run 150K/year plus benefits and productivity bonuses up to the rare (Alaska based job) for 225k/year plus benefits and bonuses.

Respect?

If you're just an employee, I wouldn't imagine a whole lot. And you're just another Internist, so I do not see why anyone would respect another IM doc more than any other.

I am sure you can work your way into CCM somehow without a fellowship being wholey hospital based? Any opinions?

BMW-

I'm sure it's possible, and again, will be highly region variable and the group or hospital which you're employed by. The trend will go towards wanting to have CC trained docs running units, but there will not be enough CC trained docs for the foreseeable future to handle all 100,000 ICU beds in 6,000 hospitals. YMMV.

 

[elwademd]

Can anyone elaborate on this newfound specialty of IM? Salary? Respect? Sounds like a good deal. NO dealing with insurance companies. Shift work. I am sure you can work your way into CCM somehow without a fellowship being wholey hospital based? Any opinions?

BMW-

no dealing with insurance companies isn't exactly true. it would depend on the set up.

there are different styles/set ups for hospitalists:

some hospitalists may work with/for a group of physicians. for example, a medical group may hire a hospitalist or hospitalists to take care of their inpatients, so the other members of the group can focus on outpatient care.

another hospitalist may contract with an insurance group/i.p.a. and cover patients with that particular insurance coverage at a set number of hospitals in that particular locale.

another set up would be for a number of hospitalists to form their own group, and then contract out their services to different medical groups/clinics in the particular area.

the numbers hernandez quoted seem to be spot on for the numbers that i've seen. here in so cal, the average is about 150k for a hospitalist first year out of residency. for perspective, 140k is about the averge for outpatient internal medicine.

 

[Nasrudin]

no dealing with insurance companies isn't exactly true. it would depend on the set up.

there are different styles/set ups for hospitalists:

some hospitalists may work with/for a group of physicians. for example, a medical group may hire a hospitalist or hospitalists to take care of their inpatients, so the other members of the group can focus on outpatient care.

another hospitalist may contract with an insurance group/i.p.a. and cover patients with that particular insurance coverage at a set number of hospitals in that particular locale.

another set up would be for a number of hospitalists to form their own group, and then contract out their services to different medical groups/clinics in the particular area.

the numbers hernandez quoted seem to be spot on for the numbers that i've seen. here in so cal, the average is about 150k for a hospitalist first year out of residency. for perspective, 140k is about the averge for outpatient internal medicine.

Interesting. So a hospitalist is an occupational definition more than a field of training?

An internist who speicalizes in hospital medicine under various infrastructures.....hmmm.

Would you care to speculate on the future of such a field in terms of any training that may develop to feed into its projected market?

Thanks.

 

[elwademd]

Interesting. So a hospitalist is an occupational definition more than a field of training?

that would be a seemingly ongoing point of debate. some people say that traditional internal medicine residencies prepare residents to be hospitalits given the amount of training that occurs in the hospital. however, there is discussion of developing a hospitalist fellowship.

Would you care to speculate on the future of such a field in terms of any training that may develop to feed into its projected market?

as stated above, there is discussion of a hospitalist fellowship. i'm not sure what it entail, and how it'd be different from another year of residency.

i think the future for hospitalists is bright. i think that in many ways, physicians are finally figuring out the work/life balance. for the most part, it seems that emergency medicine is showing many of the other fields that shift work can be one way to go. also, there are internal medicine physicians who have a hard enough time keeping up with clinic patients, that having a few patients in the hospital can tip that work/life equation in an unfavorable direction. in steps the hospitalist.

in some ways, the hospitalist relieves the burden for the outpatient physician as that outpatient physician doesn't have to worry about the inpatient side... and the hospitalist can help the hospital because he/she may be able to better care for his/her patients in a more efficient manner (after all, outpatient and inpatient medicine do vary).

 

[BMW19]

A lot of Surgeons and EM docs and even anesthesia are employees. They don't get respect? How would it differ?

BMW-

Highly variable by geographical region and how you're employed. The NEJM classifieds seem to run 150K/year plus benefits and productivity bonuses up to the rare (Alaska based job) for 225k/year plus benefits and bonuses.



If you're just an employee, I wouldn't imagine a whole lot. And you're just another Internist, so I do not see why anyone would respect another IM doc more than any other.



I'm sure it's possible, and again, will be highly region variable and the group or hospital which you're employed by. The trend will go towards wanting to have CC trained docs running units, but there will not be enough CC trained docs for the foreseeable future to handle all 100,000 ICU beds in 6,000 hospitals. YMMV.