What Is a Hospitalist Program?

The hospitalist field is a relatively new health care specialty that has shown significant growth in recent years. This program developed from the increasing demands to provide specialized and multidisciplinary care for hospitalized patients in an era of rapid expansion of health care costs and technological advancements. The goal of a hospitalist program is to ensure that patients receive adequate and efficient medical care during the entirety of their hospital stay.

Function

• A hospitalist program involves a team of health care providers that are specifically trained to monitor and treat patients during hospital stays. These doctors, nurses and staff members remain on site to ensure coordinated medical care. This allows the patient to receive the advanced level of care and organization of various medical specialties necessary with hospitalization.

History

• This branch of health care arose due to the changing dynamics of patient care that initially existed between hospitals and primary care doctors. Robert Wachter, M.D., who was one of the initial physicians to use the term "hospitalist" in 1996, states that the advent of the Medicare program in 1983 significantly altered this health care relationship due to modifications in hospitalization reimbursements. Effectively, hospitals were forced to release patients sooner in an effort to cut costs while physicians' salaries were based on the length of time that they continued to monitor and treat the patient. This initiated the rift that led many physicians to commit more time to their medical practices and likewise caused hospitals to seek new methods of improved efficiency of costs and patient care. The role of the hospitalist proved effective in this goal, and this specialty has grown dramatically in the last decade.

Expertise

• The majority of hospitalists are board-certified physicians specializing in internal medicine. However, physicians of various subspecialties ranging from pediatrics to intensive care may practice as hospitalists. Several hospitals and medical schools now incorporate hospitalist residency programs due to the emergence of this facet of health care over the past decade. Due to the severity and complexity of the medical conditions of patients requiring hospitalization, these programs are a logical development in terms of adequate medical care.

Benefits

• The advantage of a hospitalist program is that the physicians and ancillary hospital staff are devoted solely to the coordinated care of patients during their hospitalization. This eliminates the issues that primary care doctors face when attempting to monitor these patients outside of their medical practice. A properly functioning hospitalist program is one that streamlines medical testing and communication between the patient's primary care doctor and various hospital specialists. Members of the hospitalist team should be present 24/7 to address all issues that may arise during the hospital stay. When designed correctly, the hospitalist concept can eliminate medical errors and complications associated with health care providers that are forced to practice and be on call for extended time periods.

Considerations

• Since all hospitals are unique in their patient care, different hospitalist programs can also vary in effectiveness and efficiency. The common complaint from patients and family members is that they would prefer to be under the direct care of their primary care doctor rather than an impersonal hospital staff that is unfamiliar with their medical history. This is a valid point considering that many medical complications can arise when patients are being treated by several different doctors lacking a coordinated treatment plan. The primary goal of the successful hospitalist program is to overcome this particular health care issue so that the patient's doctor and the hospital staff work together to provide the highest level of medical care during the hospital stay.