The Emerging Role of “Hospitalists” in the American Health Care System

Wachter, Robert M.; Goldman, Lee

doi:10.1056/nejm199608153350713

Cited by 628 publications

(412 citation statements)

References 28 publications

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“…1 These restrictions have had many implications across several aspects of patient care, education, and clinical training, particularly for hospitalists who spend the majority of their time in this setting and are heavily involved in undergraduate and graduate clinical education in academic medical centers. 2,3 As learning environments have been shifting, so has the composition of learners. The Millennial Generation (or Generation Y), defined as those born approximately between 1980 and 2000, represents those young clinicians currently filling the halls of medical schools and ranks of residency and fellowship programs.…”

mentioning

confidence: 99%

FUTURE: New strategies for hospitalists to overcome challenges in teaching on today's wards

Martin

Farnan

Arora

2013

Journal of Hospital Medicine

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Changes in the clinical learning environment under resident duty hours restrictions have introduced a number of challenges on today's wards. Additionally, the current group of medical trainees is largely represented by the Millennial Generation, a generation characterized by an affinity for technology, interaction, and group‐based learning. Special attention must be paid to take into account the learning needs of a generation that has only ever known life with duty hours. A mnemonic for strategies to augment teaching rounds for hospitalists was created using an approach that considers time limitations due to duty hours as well as the preferences of Millennial learners. These strategies to enhance learning during teaching rounds are Flipping the Wards, Using Documentation to Teach, Technology‐Enabled Teaching, Using Guerilla Teaching Tactics, Rainy Day Teaching, and Embedding Teaching Moments into Rounds (FUTURE). Hospitalists serving as teaching attendings should consider these possible strategies as ways to enhance teaching in the post‐duty hours era. These techniques appeal to the preferences of today's learners in an environment often limited by time constraints. Hospitalists are well positioned to champion innovative approaches to teaching in a dynamic and evolving clinical learning environment. Journal of Hospital Medicine 2013;8:409–413. © 2013 Society of Hospital Medicine

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confidence: 99%

FUTURE: New strategies for hospitalists to overcome challenges in teaching on today's wards

Martin

Farnan

Arora

2013

Journal of Hospital Medicine

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“…The number of years in practice (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20), and 21+ years) was included instead of age, as those two variables were highly correlated. Time spent in email or phone conversation with other physicians was included to measure each physician's level of communication.…”

Section: Methodsmentioning

confidence: 99%

“…1 Since then, the number of hospitalists has grown rapidly, from a few thousand in the mid-1990s to more than 30,000 today. 2 There are numerous hypothetical benefits and risks of the growing numbers of hospitalists.…”

Section: Introductionmentioning

confidence: 99%

Use of Hospitalists and Office-Based Primary Care Physicians’ Productivity

Park

Jones

2014

J GEN INTERN MED

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BACKGROUND: Growth in the care of hospitalized patients by hospitalists has the potential to increase the productivity of office-based primary care physicians (PCPs) by allowing them to focus on outpatient practice. OBJECTIVE: Our aim was to examine the association between utilization of hospitalists and the productivity of office-based PCPs. DESIGN/PARTICIPANTS: The cross-sectional study was conducted using the 2008 Health Tracking Physician Survey Restricted Use File linked to the Area Resource File. We analyzed a total of 1,158 office-based PCPs representing a weighted total of 97,355 physicians. MAIN MEASURES: Utilization of hospitalists was defined as the percentage of a PCP's hospitalized patients treated by a hospitalist. The measures of PCPs' productivity were: (1) number of hospital visits per week, (2) number of office and outpatient clinic visits per week, and (3) direct patient care time per visit. KEY RESULTS: We found that the use of hospitalists was significantly associated with a decreased number of hospital visits. The use of hospitalists was also associated with an increased number of office visits, but this was only significant for high users. Physicians who used hospitalists for more than three-quarters of their hospitalized patients had an extra 8.8 office visits per week on average (p=0.05), which was equivalent to a 10 % increase in productivity over the predicted mean of 87 visits for physicians who did not use hospitalists. We did not find any significant differences in direct patient care time per visit. CONCLUSIONS: Our study demonstrates that the increase in productivity for the one-third of PCPs who use hospitalists extensively may not be sufficient to offset the current loss of PCP workforce. However, our findings provide cautious optimism that if more PCPs effectively and efficiently used hospitalists, this could help mitigate a PCP shortage and improve access to primary care services.KEY WORDS: hospitalists; primary care physician shortage; productivity.

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“…The field of hospital medicine dates to 1996, when Wachter and Goldman introduced this new model of care into American medicine [5]. As the field celebrates its twenty-first anniversary, we believe it is time to expand its mission to play an even greater role in medical education.…”

Section: Introductionmentioning

confidence: 99%

Teaching Clinical Ethics at the Bedside: William Osler and the Essential Role of the Hospitalist

McCarthy

Fins

2017

AMA Journal of Ethics

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As the field of hospital medicine celebrates its twenty-first anniversary, we believe it is time to expand its mission to play an even greater role in medical education. Given hospitalists' proximity to students and clinical material, members of this growing cohort of physicians are uniquely positioned to teach normative reasoning, professionalism, communication, and medical ethics in real time to trainees on the wards. But, to do so, we must reimagine the role of the hospitalist in graduate and postgraduate medical education.

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The Emerging Role of “Hospitalists” in the American Health Care System

Cited by 628 publications

References 28 publications

FUTURE: New strategies for hospitalists to overcome challenges in teaching on today's wards

FUTURE: New strategies for hospitalists to overcome challenges in teaching on today's wards

Use of Hospitalists and Office-Based Primary Care Physicians’ Productivity

Teaching Clinical Ethics at the Bedside: William Osler and the Essential Role of the Hospitalist

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