Considering that hospital medicine has only really taken off as a specialty within the last several years, it’s amazing how far the specialty has come.
The word “hospitalist” was first coined in 1996 when it was used in a New England Journal of Medicine article as a way of describing those internal medicine doctors who practiced inpatient medicine instead of primary care. Back then, hospital medicine was a strange new phenomenon.
Fast-forward to today, and the specialty finds itself at the forefront of American medicine. Demand for hospitalists is at an all-time high, and the chances are that your hospital is hiring right now. The number of practicing hospitalists is currently estimated at 30,000, making it one of the largest specialties in the nation. And with that expansion comes a new role. Instead of just being a temporary “fill-in” for the old-school internist who no longer wants to round in the hospital, they are now the key drivers of many of the metrics hospitals need for success. Moreover, health care reform means that the scope and responsibilities of hospital medicine doctors will expand yet further, since many reimbursement incentives are directly tied to their daily work.
Let’s take a few examples of these vital metrics:
• length of stay,
• readmission rates,
• patient satisfaction and HCAHPS scores,
• frontline cost savings and hospital utilization, and
• meaningful use implementation
The wrong type of organization will “force” these initiatives on hospitalists. In the most successful, hospitalists themselves drive the quality improvement processes, acting as leaders that are fully invested in their hospital’s future. They are uniquely placed to get a complete helicopter view of the entire medical system and gain insight into opportunities for enhanced care. For the patients, hospital medicine doctors are also the face of the hospitalization. Even when several specialists may be involved in their care, the hospital doctor takes on the role of “captain of the ship”.
Unfortunately, many hospitals are behind the curve, and don’t do all they can to nurture a strong hospital medicine department. Some of the commonly cited problems of staff turnover, low morale, and lack of engagement with other leadership, can easily be solved by developing the optimal program. Have the visionary leaders in place, hire the best doctors, and utilize a model of collaboration within a complete care team.
The strength of a hospital medicine group can make or break the whole organization, and health care administrators across the country should be engaging these doctors to help lead them into the future. Because with the right type of forward-looking and dynamic program, it’s not just hospitalists who will flourish, but the whole hospital too.
Suneel Dhand, MD, ACP Member, is a practicing physician in Massachusetts. He has published numerous articles in clinical medicine, covering a wide range of specialty areas including; pulmonology, cardiology, endocrinology, hematology, and infectious disease. He has also authored chapters in the prestigious "5-Minute Clinical Consult" medical textbook. His other clinical interests include quality improvement, hospital safety, hospital utilization, and the use of technology in health care. This post originally appeared at his blog.