1932

Abstract

Hospitalists are generalists who specialize in the care of hospitalized patients. In the 25 years since the term hospitalist was coined, the field of hospital medicine has grown exponentially and established a substantial footprint in the medical community. There are now more hospitalists than practicing physicians in any other internal medicine subspecialty. Several key forces catalyzed the growth in the field of hospital medicine, including the quality, safety, and value movements; residency duty hour restrictions; the emergence of electronic health records; and the COVID-19 pandemic. Looking ahead, we see new opportunities in the realms of technology and telemedicine, and challenges persist in regard to balancing financial considerations with increasing workload and burnout. Hospitalists must remain nimble and seize emerging opportunities to continue supporting the field's prominence and growth.

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2024-01-29
2024-04-17
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Literature Cited

  1. 1.
    Wachter RM, Goldman L. 1996. The emerging role of “hospitalists” in the American health care system. N. Engl. J. Med. 335:751417
    [Google Scholar]
  2. 2.
    Institute of Medicine (US) Committee on the Future of Primary Care, Donaldson M, Yordy K, Vanselow N. 1994. Defining Primary Care: An Interim Report Washington, DC: Natl. Acad. Press
  3. 3.
    Starfield B. 1992. Primary Care: Concept, Evaluation, and Policy Oxford, UK: Oxford Univ. Press
  4. 4.
    Starfield B, Simpson L. 1993. Primary care as part of US health services reform. JAMA 269:313639
    [Google Scholar]
  5. 5.
    Eddy DM. 1990. Clinical decision making: from theory to practice: connecting value and costs: Whom do we ask, and what do we ask them?. JAMA 264:173739
    [Google Scholar]
  6. 6.
    Pollack MM, Katz RW, Ruttimann UE, Getson PR. 1988. Improving the outcome and efficiency of intensive care: the impact of an intensivist. Crit. Care Med. 16:1117
    [Google Scholar]
  7. 7.
    Li TC, Phillips MC, Shaw L et al. 1984. Onsite physician staffing in a community hospital intensive care unit: impact on test and procedure use and patient outcome. JAMA 252:202327
    [Google Scholar]
  8. 8.
    Kitahata MM, Koepsell TD, Deyo RA et al. 1996. Physicians’ experience with the acquired immunodeficiency syndrome as a factor in patients’ survival. N. Engl. J. Med. 334:7016
    [Google Scholar]
  9. 9.
    Turner BJ, McKee L, Fanning T, Markson LE. 1994. AIDS specialist versus generalist ambulatory care for advanced HIV infection and impact on hospital use. Med. Care 32:90216
    [Google Scholar]
  10. 10.
    Paauw DS, Wenrich MD, Curtis JR et al. 1995. Ability of primary care physicians to recognize physical findings associated with HIV infection. JAMA 274:138082
    [Google Scholar]
  11. 11.
    Bennett CL, Adams J, Gertler P et al. 1992. Relation between hospital experience and in-hospital mortality for patients with AIDS-related Pneumocystis carinii pneumonia: experience from 3,126 cases in New York City in 1987. J. Acquir. Immune Defic. Syndr. 5:85664
    [Google Scholar]
  12. 12.
    Wachter RM. 2004. Hospitalists in the United States—mission accomplished or work in progress?. N. Engl. J. Med. 350:19193536
    [Google Scholar]
  13. 13.
    Wachter RM, Goldman L. 2002. The hospitalist movement 5 years later. . JAMA 287:448794
    [Google Scholar]
  14. 14.
    Wachter RM. 2015. Hospital medicine in 2015: remarkable successes and a crucial crossroads. J. Hosp. Med. 10:1283031
    [Google Scholar]
  15. 15.
    VanLare JM, Conway PH. 2012. Value-based purchasing—national programs to move from volume to value. N. Engl. J. Med. 367:29295
    [Google Scholar]
  16. 16.
    Wachter RM, Katz P, Showstack J et al. 1998. Reorganizing an academic medical service: impact on cost, quality, patient satisfaction, and education. JAMA 279:156065
    [Google Scholar]
  17. 17.
    Auerbach AD, Wachter RM, Katz P et al. 2002. Implementation of a voluntary hospitalist service at a community teaching hospital: improved clinical efficiency and patient outcomes. Ann. Intern. Med. 137:1185965
    [Google Scholar]
  18. 18.
    Wachter RM, Goldman L. 2016. Zero to 50,000—the 20th anniversary of the hospitalist. N. Engl. J. Med. 375:11100911
    [Google Scholar]
  19. 19.
    Diamond HS, Goldberg E, Janosky JE. 1998. The effect of full-time faculty hospitalists on the efficiency of care at a community teaching hospital. Ann. Intern. Med. 129:197203
    [Google Scholar]
  20. 20.
    Kroger E, Grant M. 1998. Are hospitalists truly more efficient? A natural experiment. J. Gen. Intern. Med. 13:SupplS66
    [Google Scholar]
  21. 21.
    Charlson ME, Pompei P, Ales KL, MacKenzie CR. 1987. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J. Chronic Dis. 40:37383
    [Google Scholar]
  22. 22.
    Stein MD, Hanson S, Tammaro D et al. 1998. Economic effects of community versus hospital-based pneumonia care. J. Gen. Intern. Med. 13:77477
    [Google Scholar]
  23. 23.
    Fine MJ, Auble TE, Yealy DM et al. 1997. A prediction rule to identify low-risk patients with community acquired pneumonia. . N. Engl. J. Med. 336:24350
    [Google Scholar]
  24. 24.
    Craig DE, Hartka L, Likosky WH et al. 1999. Implementation of a hospitalist system in a large health maintenance organization: the Kaiser Permanente experience. Ann. Intern. Med. 130:35559
    [Google Scholar]
  25. 25.
    Freese RB. 1999. Clinical, logistical, and political issues in creating a hospitalist system. Ann. Intern. Med. 130:35054
    [Google Scholar]
  26. 26.
    Rifkin WD, Connor DS, Eichorn A, Rose DN. 1999. Comparison of hospitalists and primary care internists in the care of inpatients with pneumonia. J. Gen. Intern. Med. 14:supplS118
    [Google Scholar]
  27. 27.
    Davis KM, Koch KE, Harvey JK et al. 2000. Effects of hospitalists on cost, outcomes, and patient satisfaction in a rural health system. Am. J. Med. 108:862126
    [Google Scholar]
  28. 28.
    Halpert AP, Pearson SD, LeWine HE, Mckean SC. 2000. The impact of an inpatient physician program on quality, utilization, and satisfaction. Am. J. Manag. Care 6:54955
    [Google Scholar]
  29. 29.
    Bellet PS, Whitaker RC. 2000. Evaluation of a pediatric hospitalist service: impact on length of stay and hospital charges. Pediatrics 105:47884
    [Google Scholar]
  30. 30.
    Landrigan C, Srivastava R, Muret-Wagstaff S. 2000. Outcomes of hospitalization in pediatric patients insured by HMOs: comparison of care by hospitalists and traditional academic providers. Pediatr Res. 47:204A Abstr. )
    [Google Scholar]
  31. 31.
    Srivastava R, Landrigan C, Muret-Wagstaff S. 2000. Impact of a managed care hospitalist system in academic pediatrics. Pediatr Res. 47:228A Abstr. )
    [Google Scholar]
  32. 32.
    Srivastava R, Landrigan C, Muret-Wagstaff S. 2001. Cost savings for patients with acute conditions cared for by pediatric hospitalists in a tertiary care center. Pediatr Res. 49:125A Abstr. )
    [Google Scholar]
  33. 33.
    Fernandez A, Grumbach K, Goitein L et al. 2000. Friend or foe? How primary care physicians perceive hospitalists. Arch. Intern. Med. 160:1929028
    [Google Scholar]
  34. 34.
    López L, Hicks LS, Cohen AP et al. 2009. Hospitalists and the quality of care in hospitals. . Arch. Intern. Med. 169:15138994
    [Google Scholar]
  35. 35.
    Institute of Medicine (US) Committee on Quality of Health Care in America, Kohn LT, Corrigan JM, Donaldson MS. 2000. To Err Is Human: Building a Safer Health System Washington, DC: Natl. Acad. Press
  36. 36.
    Institute of Medicine (US) Committee on Quality of Health Care in America 2001. Crossing the Quality Chasm: A New Health System for the 21st Century Washington, DC: Natl. Acad. Press
  37. 37.
    The core competencies in hospital medicine: a framework for curriculum development by the Society of Hospital Medicine. 2006. J. Hosp. Med. 1:Suppl. 1295
    [Google Scholar]
  38. 38.
    Philibert I, Friedmann P, Williams WT. 2002. ACGME Work Group on Resident Duty Hours, Accreditation Council for Graduate Medical Education new requirements for resident duty hours. JAMA 288:111214
    [Google Scholar]
  39. 39.
    Saint S, Flanders SA. 2004. Hospitalists in teaching hospitals: opportunities but not without danger. J. Gen. Intern. Med. 19:439293
    [Google Scholar]
  40. 40.
    Chung P, Morrison J, Jin L et al. 2002. Resident satisfaction on an academic hospitalist service: time to teach. Am. J. Med. 112:7597601
    [Google Scholar]
  41. 41.
    Hunter AJ, Desai SS, Harrison RA, Chan BK. 2002. Medical student evaluation of the quality of hospitalist and nonhospitalist teaching faculty on inpatient medicine rotations. Acad. Med. 79:17882
    [Google Scholar]
  42. 42.
    Goldenberg J, Glasheen JJ. 2008. Hospitalist educators: future of inpatient internal medicine training. Mt. Sinai J. Med. 75:543035
    [Google Scholar]
  43. 43.
    Martin SK, Farnan JM, Arora VM. 2013. Future: new strategies for hospitalists to overcome challenges in teaching on today's wards. J. Hosp. Med. 8:740913
    [Google Scholar]
  44. 44.
    Landry JB, Seltz LB, O'Hara K. 2023. TEAMwork! An innovative hospital medicine teaching program to enhance learners’ educational experience. Acad. Med. 98:446367
    [Google Scholar]
  45. 45.
    Sehgal NL, Wachter RM, Vidyarthi AR. 2014. Bringing continuing medical education to the bedside: the University of California, San Francisco Hospitalist Mini-College. J. Hosp. Med. 9:212934
    [Google Scholar]
  46. 46.
    Connor DM, Narayana S, Dhaliwal G. 2021. A clinical reasoning curriculum for medical students: an interim analysis. Diagnosis 9:226573
    [Google Scholar]
  47. 47.
    Office of the National Coordinator for Health Information Technology 2022. National trends in hospital and physician adoption of electronic health records. HealthIT.gov. https://www.healthit.gov/data/quickstats/national-trends-hospital-and-physician-adoption-electronic-health-records
    [Google Scholar]
  48. 48.
    Stephan T. 2015. Hospitalists play key role developing electronic health records. Hospitalist July 6. https://www.the-hospitalist.org/hospitalist/article/122322/hospitalists-play-key-role-developing-electronic-health-records
    [Google Scholar]
  49. 49.
    Leviss J, Kremsdorf R, Mohaideen MF. 2006. The CMIO—a new leader for health systems. J. Am. Med. Inform. Assoc. 13:557378
    [Google Scholar]
  50. 50.
    Society of Hospital Medicine 2014. State of hospital medicine: nationwide demand continues for hospitalists Press Release, Sep. 5 Society of Hospital Medicine Philadelphia, PA: https://www.hospitalmedicine.org/news-publications/press-releases/state-of-hospital-medicine.-nationwide-demand-continues-for-hospitalists/
  51. 51.
    Antoon JW, Grijalva CG, Thurm C et al. 2021. Factors associated with COVID-19 disease severity in US children and adolescents. J. Hosp. Med. 16:1060310
    [Google Scholar]
  52. 52.
    Linker AS, Kulkarni SA, Astik GJ et al. 2021. Bracing for the wave: a multi-institutional survey analysis of inpatient workforce adaptations in the first phase of COVID-19. J. Gen. Intern. Med. 36:11345661
    [Google Scholar]
  53. 53.
    Keniston A, Sakumoto M, Astik GJ et al. 2022. Adaptability on shifting ground: a rapid qualitative assessment of multi-institutional inpatient surge planning and workforce deployment during the COVID-19 pandemic. J. Gen. Intern. Med. 37:15395664
    [Google Scholar]
  54. 54.
    Auerbach A, O'Leary KJ, Greysen SR et al. 2020. Hospital ward adaptation during the COVID-19 pandemic: a national survey of academic medical centers. J. Hosp. Med. 15:848388
    [Google Scholar]
  55. 55.
    Shepperd S, Doll H, Angus RM et al. 2009. Avoiding hospital admission through provision of hospital care at home: a systematic review and meta-analysis of individual patient data. CMAJ 180:217582
    [Google Scholar]
  56. 56.
    Leff B, Burton L, Mader SL et al. 2005. Hospital at home: feasibility and outcomes of a program to provide hospital-level care at home for acutely ill older patients. Ann. Intern. Med. 143:11798808
    [Google Scholar]
  57. 57.
    Truong T-T, Siu AL. 2024. The evolving practice of hospital at home in the United States. Annu. Rev. Med. 75: In press
    [Google Scholar]
  58. 58.
    Bloom-Feshbach K, Berger RE, Dubroff RP et al. 2021. The virtual hospitalist: a critical innovation during the COVID-19 crisis. J. Gen. Intern. Med. 36:6177174
    [Google Scholar]
  59. 59.
    Gutierrez J, Moeckli J, Holcombe A et al. 2021. Implementing a telehospitalist program between veterans health administration hospitals: outcomes, acceptance, and barriers to implementation. J. Hosp. Med. 16:315663
    [Google Scholar]
  60. 60.
    Kuperman EF, Linson EL, Klefstad K et al. 2018. The virtual hospitalist: a single-site implementation bringing hospitalist coverage to critical access hospitals. J. Hosp. Med. 13:1175963
    [Google Scholar]
  61. 61.
    Becker CD, Forman L, Gollapudi L, Nevins B, Scurlock C. 2021. Rapid implementation and adaptation of a telehospitalist service to coordinate and optimize care for COVID-19 patients. Telemed. e-Health 27:438896
    [Google Scholar]
  62. 62.
    Ryan PP, Hawkins KL, Altman S et al. 2021. A novel virtual hospital at home model during the coronavirus disease 2019 (COVID-19) pandemic. Infect. Control. Hosp. Epidemiol. 42:9114042
    [Google Scholar]
  63. 63.
    Dugani SB, Geyer HL, Maniaci MJ et al. 2021. Psychological wellness of internal medicine hospitalists during the COVID-19 pandemic. . Hosp. Pract. 49:14755
    [Google Scholar]
  64. 64.
    Dugani SB, Fischer KM, Schroeder DR et al. 2022. Wellness of hospitalists and hospital medicine advanced practice providers during the COVID-19 pandemic, 2020–2021. J. Hosp. Med. 17:425967
    [Google Scholar]
  65. 65.
    Zhang X, Lin D, Pforsich H, Lin VW. 2020. Physician workforce in the United States of America: forecasting nationwide shortages. Hum. Resour. Health 18:8
    [Google Scholar]
  66. 66.
    Levine DM, Mitchell H, Rosario N et al. 2021. Acute care at home during the COVID-19 pandemic surge in Boston. J. Gen. Intern. Med. 36:11364446
    [Google Scholar]
  67. 67.
    Auerbach AD, Astik GJ, O'Leary KJ et al. 2023. Prevalence and causes of diagnostic errors in hospitalized patients under investigation for COVID-19. J. Gen. Intern. Med. 38:8190210
    [Google Scholar]
  68. 68.
    Fang MC, Fan D, Sung SH et al. 2019. Treatment and outcomes of acute pulmonary embolism and deep venous thrombosis: the CVRN VTE study. Am. J. Med. 132:1214501457.e1
    [Google Scholar]
  69. 69.
    Prasad PA, Fang MC, Abe-Jones Y et al. 2020. Time to recognition of sepsis in the emergency department using electronic health record data: a comparative analysis of systemic inflammatory response syndrome, sequential organ failure assessment, and quick sequential organ failure assessment. Crit. Care Med. 48:22009
    [Google Scholar]
  70. 70.
    Rajkomar A, Ranji SR, Sharpe B. 2017. Using the electronic health record to identify educational gaps for internal medicine interns. J. Grad. Med. Educ. 9:110912
    [Google Scholar]
  71. 71.
    Auerbach AD, Patel MS, Metlay JP et al. 2014. The Hospital Medicine Reengineering Network (HOMERuN): a learning organization focused on improving hospital care. Acad. Med. 89:341520
    [Google Scholar]
  72. 72.
    Renner CS, Sumarsono A, Mathew A et al. 2022. Scholarly productivity and growth of academic hospital medicine full professors. J. Hosp. Med. 17:750916
    [Google Scholar]
  73. 73.
    Kulkarni SA, Keniston A, Linker AS et al. 2023. Building a thriving academic hospitalist workforce: a rapid qualitative analysis identifying key areas of focus in the field. J. Hosp. Med. 18:432936
    [Google Scholar]
  74. 74.
    Shannon EM, Chopra V, Greysen SR et al. 2021. Dearth of hospitalist investigators in academic medicine: a call to action. J. Hosp. Med. 16:318991
    [Google Scholar]
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