Patients often ask when they are admitted to the hospital, “hey doc, exactly what is a hospitalist anyways?” This, at times is followed-up by a second comment that “Dr. Smith is my outpatient doctor and used to make rounds in the hospital.”
This is a great opportunity to discuss hospitalist medicine briefly and some trends in hospitalist medicine that may be pertinent to our patients. In brief terms, a hospitalist is a physician who is trained in internal medicine (majority), family medicine, or a subspecialty of internal medicine, who is a specialist in acutely ill, hospitalized patients. Like ER physicians, hospitalists are defined by the site of care, as inpatient specialists, rather than by an organ system (Cardiology, Rheumatology, etc.). Hospitalists, like the doctors at SHMG, work very closely with your outpatient physician, keeping them informed of your progression and especially during hospital admission and discharge planning, to ensure a safe transition of care.
Hospitalist medicine is actually one of the fastest growing specialties in the US over the past 20 years, as hospitals note an overall increase in the quality of care and decrease in costs when utilizing hospitalists. The term was first described by Wachter and Goldman in a New England Journal of Medicine Article in 1996, “The emerging role of “hospitalists” in the American health care system.” N Engl J Med 335 (7): 514-7.
For the past 20 years, there has been an increasing trend by which primary care physicians are focused more on outpatient care due to scheduling and time constraints and inpatient care has become more difficult to manage. In addition, the growing complexity of medical care has made a dedicated inpatient physician widely acknowledged as a clear benefit for patient care. The ability to quickly act with new information about very medically complex and sick patients, and familiarity with a health systems’ inpatient specialty and subspecialty consultants, radiologists, ED physicians, nurses, and allied health staff can make a remarkable difference for patient care.
In addition to patient care, many hospitalists are involved in quality improvement work within the hospital, as well as assisting the health system with inpatient flow. Research shows that hospitalists reduce the length of stay, treatment costs and improve the overall efficiency of care for hospitalized patients. (Rachoin, JS, et. al., “The impact of hospitalists on length of stay and costs: systematic review and meta analysis.” 2012 Database of Abstracts of Reviews of Effects (DARE): Quality Assessed Reviews.”
Finally, many hospitalist groups, especially SHMG, care deeply about safe care transitions. We round at a majority of Skilled Nursing Facilities our patients may be discharged to, as well as perform home visits where indicated. Many patients are also contacted by our dedicated pharmacist to ensure medication reconciliation is done appropriately at discharge. Finally, your hospitalist will contact a patient’s outpatient physician to let them know what the plan of care on discharge will be, so that the patient has adequate follow-up on discharge.
Thus, a hospitalist is a dedicated inpatient physician who is responsible for the acute care of a patient- and much more. Ensuring the highest quality of care in an efficient and comprehensive, compassionate, coordinated fashion, with safe transitions of care is what we truly care about.
— Sid Anand, M.D., M.B.A., Stanford Hospitalist Medical Group Physician