The growing shortage of general internal medicine physicians is occurring at a time when an aging population will require more, not fewer, to provide primary care. It’s estimated that fewer than 20 percent of those physicians who complete a general internal medicine residency intend to begin an active practice as general internists.
Instead, many pursue continued training in various medical subspecialties or they become hospitalists and practice inpatient medicine at major hospitals across the country.
Those who choose to practice as “hospitalists” are either employed by a hospital or join a hospitalist group that contracts with a hospital. Hospitalists are in the hospital at all times of the day and night. They provide overall medical management for patients who do not have a physician or for those who are admitted by other medical subspecialists who request that hospitalists assume responsibility for the overall medical management and discharge of the patient.
I know of a hospital where 90 percent of the patients have been assigned to the care of a hospitalist.
The advantages to the hospital, the nursing staff and other physicians are obvious.
Hospitalized patients needing to be seen by a physician can do so more quickly than waiting for the patient’s physician to arrive from the office. Patients who do not have a personal physician can be admitted immediately rather than wait for an on-call physician to arrive. And for the nursing personnel, there is always a hospitalist physician available to assist and advise a nurse with a patient problem.
For physicians who assign their patients to the hospitalist, it means more available time to see patients in the office without the interruption of attending to a hospitalized patient.
For some patients, seeing a hospitalist for the first time in the hospital can be disconcerting and surprising. There is a concern the hospitalist will not be as familiar with all of the patient’s medical information compared to their own primary physician. In addition, the continuity of care between discharge from the hospital and the return to the primary physician may not be optimal.
If you’ve been a patient in a hospital and had your medical care handled by a hospitalist, what has been your experience? Do the advantages outweigh the disadvantages as you perceive them? Do you view this major change in hospital inpatient care positively or negatively?
Mike Stephens blogs regularly at Action for Better Healthcare.