Hospitalists are medical doctors who specialize in hospital-based services focused on the inpatient population only. The trend toward hospital specialization was initiated around 2006 in an effort to streamline hospital-based services to improve patient outcomes while ensuring efficient delivery of services.
When patients were admitted to hospitals under the traditional system, the primary physician remained the overall care coordinator, which created communication issues especially with critical care patients. Physicians made their hospital rounds in the morning, and they did not always follow a daily visitation schedule. The doctors were contacted by the hospital-based team if questions or emergencies arose.
Prioritizing Inpatient Care
The role of the hospitalist in the health care system evolved over the years, and health care experts realigned the scope and significance of their role in patient care. A hospitalist is a physician whose main concern is the medical care of patients admitted for hospital confinement for whatever reason. The job functions include delivering general medical care and patient education along with indirect care functions such as research support and leadership roles in the hospital.
The emphasis on improving delivery of health services to a diverse population means that the hospitalist function cannot be too much of a generalist. A hospital may employ a hospitalist for pediatric patients, a separate one for adults and a different one for geriatric admissions. Core concerns of these functions focus on the practice of hospital medicine for the entire duration of the patients’ stay. It is no longer unusual for patients not to see their primary physician between the time they are admitted and until they are discharged from the hospital.
Understanding the Role of the Hospitalist
The hospitalist is the doctor of record during the patient’s confinement. This physician and the health providers of the hospital unit will create, apply and monitor the results of the patient’s treatment plan. The hospital team takes charge of accessing the patient’s medical records and conferring with the patient’s primary doctor and other specialists as needed.
Needless to say, the care and treatment of a hospitalized patient differs vastly from that of an ambulatory patient. Issues such as patient safety, prevention of cross-infections, palliative care and quality of daily care come into play. Hospital-based medical professionals are trained to address these issues as part of their protocol.
Improving the Delivery of Care
Hospital medicine as a specialization is fairly new, but health institutions with hospitalists on staff have proven that this is an efficient strategy for delivering quality care to hospitalized patients. These hospital-based specialists are available for patient care and monitoring on a 24-hour basis, ensuring that treatment decisions can be adjusted quickly. Coordination of care is convenient, efficient and cost effective for the hospital, the patient and health insurance providers.
Physicians that specialize in hospital medicine come from diverse backgrounds and with different board certifications. When the field was new, many of the doctors involved with hospital medicine specialized in internal medicine. This is no longer the case as medical and osteopathic doctors are shifting to hospital-based employment under different employment models. Some of these hospital specialists are employed directly by the hospitals while others are employed by physician management companies or partnerships.
Hospital-based physicians will play a bigger role in the health care system as government mandates underline the importance of access to quality health services for everyone. Hospitalists will play a bigger role in ensuring patient-focused, cost-effective and solution-centered patient care systems.