Practice Trends and Characteristics of US Hospitalists From 2012 to 2018

Shultz, Kaitlyn; Unruh, Mark Aaron; Jung, Hye–Young

doi:10.1001/jamahealthforum.2021.3524

Cited by 5 publications

(10 citation statements)

References 5 publications

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“…Other recent research suggests that between 2012 and 2018, nearly 25% of hospitalists first identified in 2012 shifted their full‐time practice to other settings while still doing part‐time hospitalist work 11 . Our data on PECOS‐identified hospitalists who no longer meet the 90% threshold seem to affirm that some hospitalists transition to nonhospital settings, such as skilled nursing facilities or office‐based settings.…”

Section: Discussionsupporting

confidence: 53%

“…This requires further exploration. Third, hospitalists may be increasingly engaged in nonclinical work, such as quality improvement and administrative tasks, requiring groups to expand to fill vacated clinical responsibilities.Other recent research suggests that between 2012 and 2018, nearly 25% of hospitalists first identified in 2012 shifted their fulltime practice to other settings while still doing part-time hospitalist work 11. Our data on PECOS-identified hospitalists who no longer meet the 90% threshold seem to affirm that some hospitalists transition to nonhospital settings, such as skilled nursing facilities or office-based settings.…”

supporting

confidence: 57%

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Growth trends of the adult hospitalist workforce between 2012 and 2019

Lapps¹,

Flansbaum

Leykum

et al. 2022

Journal of Hospital Medicine

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Background Accurately identifying the number of practicing hospitalists across the United States continues to be a challenge. Characterizing the workforce is important in the context of healthcare reforms and public reporting. Objective We sought to estimate the number of adult hospitalists practicing in the United States over an 8‐year period, to examine patterns in growth, and begin to explore billing patterns. Design, Settings, and Participants Retrospective study using national Medicare Part B claims datasets. We applied a commonly used 90% threshold of billing hospital visit‐associated Healthcare Common Procedure Coding System codes to identify adult hospitalists in publicly available Medicare Provider Utilization and Payment data for 2012–2019. We then analyzed billing patterns for those identified hospitalists. Main Outcomes and Measures Identify trends in the number of identified adult hospitalists, including those self‐identified. Compare hospitalists' billing to that of non‐hospitalist Internal Medicine and Family Medicine physicians. Results We saw more than a 50% growth rate of practicing adult hospitalists between 2012 and 2019. In 2019, we identified 44,037 adult hospitalists. Conclusions The number of adult hospitalists continued to grow at a consistent rate, such that hospitalists are in the top five largest physician specialties in the United States. In the absence of more formal identification and consistent use by hospitalists, a threshold continues to be a meaningful tool to characterize the workforce.

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Section: Discussionsupporting

confidence: 53%

supporting

confidence: 57%

Growth trends of the adult hospitalist workforce between 2012 and 2019

Lapps¹,

Flansbaum

Leykum

et al. 2022

Journal of Hospital Medicine

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“…Dr Houtrow's comparison to previous studies, however, warrants a larger discussion. Unlike the University of Michigan study that was a single-center study of faculty with a low response rate (25.9%), 3 our study was conducted on a national level, focused on internal medicine residents and had a high response rate (72.5%). The study findings-12.8% of internal medicine residents self-reported experiencing sexual harassment 1 -parallel the findings of other large multisite survey-based studies with similar response rates, including 1 centered on early career development awardees and another study of surgical residents where sexual harassment was reported by 16.3% and 10.3% of respondents, respectively.…”

mentioning

confidence: 99%

Changes in Physician Work Hours and Implications for Workforce Capacity, 2001 to 2021

2023

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To the Editor We read with interest the recent cross-sectional study by Drs Goldman and Barnett 1 on the gap in physician work hours between men and women, which has gradually narrowed during the past 20 years. We agree with the authors that a lack of information on physician specialty in the Current Population Survey was an important study limitation. In the US, the most influential confounder on physician work hours from 2001 to 2021 was the introduction of the hospitalist workforce. A study in 2022 2 reported a 50% growth rate of adult hospitalists, defined strictly by the claims pattern in 2012 to 2019. The authors identified 44 037 actively practicing adult hospitalists in 2019, comprising 1 of the top 5 largest physician specialties in the US.The hospitalist workforce compared with all other medical specialties pays tremendously higher attention to the design of scheduling and workload. 3 Hospitalists typically use block schedules of 7 days consisting of 12-hour shifts, followed by 7 days off; although 14-day block schedules are also used in some programs. Notably, to our knowledge, no significant differences in hospitalist scheduling or shift design between men and women have been reported. With the growth of hospitalists and women physicians who dominate the hospitalist workforce, the average weekly work hours will undoubtedly equalize among genders, converging to the mean with time. Therefore, the growth of hospitalists may explain the decrease in work hours and the gap between genders.

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“…(2) Are inpatient care models changing with this hospitalist expansion? and, most importantly, (3) Is this trend improving patient outcomes? Undoubtedly, there are several drivers of the rise in the hospitalist profession, including employment of hospitalists for co-management on specialty services, 2 expanding roles of geriatrician-hospitalists in palliative and hospice care, more parttime hospitalists, 3 work-hour reductions leading to smaller censuses on resident services, and hospital leadership's attraction to the greater revenue created by hospitalists through more high-severity billing and reduced length of stay (LOS).…”

mentioning

confidence: 99%

“…and, most importantly, (3) Is this trend improving patient outcomes? Undoubtedly, there are several drivers of the rise in the hospitalist profession, including employment of hospitalists for co-management on specialty services, 2 expanding roles of geriatrician-hospitalists in palliative and hospice care, more parttime hospitalists, 3 work-hour reductions leading to smaller censuses on resident services, and hospital leadership's attraction to the greater revenue created by hospitalists through more high-severity billing and reduced length of stay (LOS). 4,5 Perhaps one of the biggest drivers is the exodus of primary care physicians (PCPs) from inpatient rounding, a reflection of the intense demands that have grown in both hospital and ambulatory care settings.…”

mentioning

confidence: 99%