HOSPITALIST: A NEW MEDICAL SPECIALTY

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HOSPITALIST:  A NEW MEDICAL SPECIALTY

We have all heard about radiologists, urologists, and even pathologists, but what is a hospitalist?  Is it a CEO that runs a hospital?

 

Well, actually, it is a redesigned internist who works only in a hospital managing medical care for other doctors.  Internists that never became sub-specialized, now have found their niche in hospitals.

Hospitalists now can be found in almost all areas of our country.  The dynamics of medical care over the last 10 years has resulted in a tripling of the number of doctors that identify themselves as hospitalists.  Medical claims for evaluation and management services in the hospital by these new specialists called hospitalists have increased almost 400%.

The odds of you being treated by a hospitalist vary by regions, with more than a 70% chance in some hospital-referral regions.  Forty percent of community hospitals now have a hospitalist program;  California is leading the way with 60% of their hospitals having such programs. 

Over 45% of hospitals have at least three hospitalists, with an average of 11 in major teaching hospitals and 3 in non teaching hospitals.  If you live in St. Cloud Minnesota, Mesa Arizona, Appleton Wisconsin or Austin Texas you have an 80% chance of being treated by a hospitalist.  

Hospitalists are now in 85% of teaching hospitals and 40% of non-teaching hospitals.  Over 85% of hospitalists are trained internists, and they do over 96% of their work in hospitals.  The other 15% are general practitioners and pediatricians.  They care now for more admissions from the emergency room, and do referral work for orthopedic doctors, and patients with neurological problems. 

In the past, a newly trained cardiologist took a part time job in the hospital, as he was developing his outpatient practice.  The career stability of hospitalists seems now established, with over 90% of hospitalists staying in their new specialty and find no need to have an outpatient practice.

This means internists will see you more quickly when you arrive at a hospital.  You will, however,be treated by a doctor that does not know your problems as well as your own doctor.  If you are going to have a hip or knee replacement, you will get an evaluation and medical care from a hospitalist, not your busy cardiologist.

Being a hospitalist is now a fine way to finish a medical career after private practice.  Is the hospitalist, however,  abreast of current subspecialty problems?  Who will the hospitalist call  when he does not know the answer to your perplexing medical problem?

 Time will tell, in the ever-changing medical world. 

Visit www.drneedles.com for more medical blogging on controversial current problems in medicine.  As always, your comments are always appreciated.

Source: NEJM Mar.12, 2009