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| Hospitalists: Slowly Accepted,
Fast-Growing of the Scene If you haven’t yet come across that new brand of medical professional called a hospitalist, chances are that one (or more) will soon be coming to a hospital near you. According to estimates, somewhere around 5,000 of them currently practice at approximately one-third of U.S. hospitals, and that number is expected to increase to at least 19,000 by the end of the decade. What’s a hospitalist, and aside from the fact that their numbers are ballooning, what should you know about them? First things first, a hospitalist is a hospital-based specialist physician who cares for patients while they are hospitalized. At the time of hospital discharge, the patients return to the care of their out-patient physician. As for their impact on the system and quality of care, a survey of various studies on this issue found that hospitalists help cut inpatient cost and reduce average lengths of stays (Janyary 23, 2002, Journal of the American Medical Association). Researchers say, too, that all this is accomplished without any diminishing of care. What has been mainstream medicine’s attitude toward these new kids on their block? As you might imagine, initially there was resistance to the idea that hospital-based physicians would take over primary care physicians’ money-making turf. Now, though, according to statistics from the American Academy of Family Physicians (AAFP), approximately 20 percent of AAFP members use hospitalists (February 19, 2001, American Medical News). The reasons behind this turnaround in thinking still have to do with, among other factors, bottom-line issues. Specifically, it slowly dawned on primary care physicians that by relying on hospitals to oversee the care of their hospitalized patients, the office-based docs could see more patients in the office. This strategy, they reasoned, "more than makes up for any revenue lost by not seeing their patients at the hospital," in the word of the American Medical News article. Still, most agree that the option to use hospitalists should be voluntary, and at this time that is the case. And too, as more than one commentator on this emerging landscape has said, the wise hospitalist will recognize that he or she has two customers: the primary care physician – on whose behalf the hospital oversees hospitalized patients – and the patient.
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