Hospital medicine has come a long way since the term hospitalist was coined slightly more than a decade ago. SHM estimates the need for 30,000 practicing hospitalists within the next decade.
Filling an available hospitalist position is a two-way process that involves considerations and negotiations at various levels. When looking for the suitable hospitalist job, it is critical that you think both about what your potential employer needs and what you expect from the role you seek. The following insights provide a gauge of what an employer is looking for in a hospitalist applicant.
1) Clinical and procedural skills. Good clinical acumen is fundamental to being a successful hospitalist. As you complete residency training, your professional references are a reliable means for others to judge clinical skills. It’s important that your references comment on your clinical proficiency in their letters. Procedural skills always are welcome but by no means mandatory.
In larger facilities, where residents in training or specialists do many procedures, the program may not insist on procedural skills. On the other hand, some hospital medicine programs may require a proficiency in ICU procedures, which include intubations, central line placement, and A-line placements to mention a few. The SHM publication The Core Competencies in Hospital Medicine: A Framework for Curriculum Development is a great resource for understanding the knowledge and skills expected of a hospitalist physician.
2) Professionalism and teamwork. There are an extraordinary number of healthcare providers a hospitalist needs to work with. In addition to establishing a courteous rapport with patients and their families, good communication with primary care physicians, specialists, nursing staff, case managers, midlevel providers, and administrative and secretarial staff is essential. With this diversity of interactions, professionalism and teamwork are highly regarded and go a long way in establishing you as proficient hospitalist. An applicant’s professionalism is not only judged during the interview period but also confirmed by references. An unwavering positive attitude and commitment to a healthy work environment also are attributes that are recognized by a potential employer.
3) Quality improvement focus. Quality improvement activities and participation in such programs have rightly received unprecedented attention. SHM data indicate that 86% of hospitalist groups are active in quality improvement initiatives. Many hospital medicine programs participate in some form of Medicare pay-for-performance initiatives in order to ensure evidence-based patient care, better health outcomes, and reduce preventable complications.
A commitment to and active interest in quality improvement is highly desirable. Prior participation in and/or research for programs such as venous thromboembolism (VTE) prophylaxis, inpatient glycemic control, fall preventions, CHF optimization, medicine reconciliation pathways, and other evidence-based measures are a definite plus. In addition, specific training in areas such as perioperative care, improving safety of transitions of care, and stroke management are beneficial. Elaborating on any systems enhancement projects undertaken especially during hospital medicine clinical rotations/electives and/or fellowships will be invaluable.
4) Leadership skills. Nonclinical and administrative responsibilities are an important element of many hospitalist programs. Interest in various committees and an ability to assume leadership roles reflect favorably on your application. A good hospital medicine program will often encourage your interest in fostering the program and invite your involvement in initiatives to promote good patient care and facilitate fiscal strength.
An applicant should inquire about opportunities to participate in organizational committees and develop leadership skills, as this will be important for your professional growth. Take the time to point out any previous committee involvement in national healthcare organizations such as SHM.