The term “hospitalist” has only been in existence since 1996 when the New England Journal of Medicine first coined the term. In the last couple of decades, the field has expanded from a few hundred hospitalists to more than 30,000, but there remains a good deal of confusion about the definition and responsibilities of this “new” medical professional.
Defining the Hospitalist Role
Most importantly, hospitalists are board-certified physicians. Although the term does not seem to imply that these professionals are doctors, nurse practitioners and physicians’ assistants, they have received years of education and extensive hands-on residency training.
The majority of hospitalists have received their instruction and certification in internal medicine, but there are some who have general or family practice training instead. A few have even chosen to focus on pediatrics, psychiatry or another specialty. However, instead of joining or starting a specialized practice after graduation, hospitalists have chosen to focus their professional patient care on the hospital residents.
The role of the hospitalist initially became important when physicians attending to both inpatient and outpatient populations were increasingly overwhelmed by their responsibilities. Since these doctors were finding it too difficult to manage visiting the hospital to attend to their admitted patients while also running a successful outpatient office, hospitalists evolved to help manage their colleagues’ hospital patients and provide high quality care.
Responsibilities of the Hospitalist
With specific work hour limits for medical professionals, the role of the hospitalist has become increasingly important for many facilities. By employing hospitalists to handle day-to-day patient care, there can be a physician available 24 hours a day, seven days a week, including nights, weekends and holidays, times when hospitals are typically understaffed by quality doctors.
Hospitalists are generally scheduled to work seven days in a row, each for a 12-hour shift. This period is then followed by a week or more off before the rotation begins again. During this time, hospitalists are responsible for the following actions:
Diagnosis
Treatment plans
Procedures within their scope of practice
Collaboration with colleagues
Communication with colleagues and patients’ families
Coordination of patient care
Safe transition of patient care within the hospital or to other facilities
Use of hospital resources
Each of these assigned tasks was initially devised to enhance the care for inpatients, especially those with acute or complex conditions that needed more careful monitoring. With a hospitalist constantly on-call and in the building, patients are afforded immediate medical care by a highly trained physician.
In addition to providing improved patient care, hospitals have found that the hospitalist role has reduced healthcare costs and improved facility efficiency. Patients often avoid unnecessary tests and procedures because of regular care, and their recovery is quicker due to frequent on-site checks and treatment adjustments. Patients’ families are also more informed because hospitalists are available for questions, discharge instructions and emergency care. With all of these responsibilities undertaken by the hospitalist, primary care physicians are able to spend more time in-office, receiving updates of patient care through the hospitalist’s communications.
