What is Fueling the Immense Demand for Hospitalists?

Hospitalists have existed as a specialty for only a decade, but they have quickly become the most popular specialists in the medical community and in the locum tenens market.  These physicians who are primarily tasked with caring for patients in a hospital setting are among the most sought-after due to their skills in patient treatment, hospital administration, research and teaching. According to the Society of Hospital Medicine, the number of hospitalists has increased to 30,000, an almost 170 percent increase from 2003 to 2010. According to a 2011 Staffing Industry Analysis, hospitalist locum tenens generated the most revenue of any medical specialty. Almost 17 percent of all locum tenens revenue—totaled at $548 million—was from hospitalist placements, followed at 14 percent by emergency medicine placements. This hospitalist-generated revenue was 34 percent greater than the previous year. There are a number of reasons why hospitalists are the fastest growing specialty in U.S. medical history. The first is related to their utility. Due to the intense array of health cases that arrive at the doorstep of a hospital, a physician who is experienced at handling a multitude of medical scenarios is likely to flourish in such an environment. Secondly, hospitalists are proficient in prompt patient management which helps raise patient satisfaction ratings. Because they are intimately involved in inpatient care at the onset, they are more efficient decision makers, discharging patients when they no longer need inpatient care, leading to lower costs and nosocomial infections, while improving overall care. That is not to say that these specialists are less concerned about their patients; the reality is quite the opposite. Hospitalists are focused entirely on clinical care, diverting hospital resources to patients as the need arises. In many cases, hospitalists are the final arbiters of care, balancing organizational resources with the needs of seriously ill patients. Because hospitalists are typically in the hospital throughout the day, they can make treatment decisions immediately that can be revisited if necessary when real time responses arise. From a hospital administration point of view, hospitalists facilitate better patient care while also improving organizational efficiency. A study by James Goodwin found that because hospitalists tend to discharge patients earlier—on average, 12 hours earlier—they better utilize resources and generate more revenue. This generally saved about $282 per patient for the hospital. On the flip side, the increased demand for this specialty has also stoked interest in newly minted doctors. Young physicians are trained in hospital settings, so transitioning to a hospital-based specialty is a natural fit.  These young professionals also find that the traditional seven-on-seven-off schedule which hospitalists often utilize is more conducive for family, part time work and volunteering. Finally, hospitalists are typically not on-call, so there are no hidden responsibilities that other specialists often endure. There are some drawbacks to this popular specialty. Many patients do not necessarily warm up to a physician who they are unlikely to interact with following their hospital stay. Some are likely to find a desire to quickly discharge a patient as discourteous or unprofessional. These reasons and the considerable case load can inhibit the cultivation of relationships with patients, which many physicians view as integral to the practice of medicine.

Written by:  Robert Moghim, M.D., CEO- Moghim Medical Consulting Inc.

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