My path to the SHM presidency has been a long and winding one. After paying back some student loans courtesy of the U.S. Air Force, I joined a busy traditional family medicine practice. Routinely, we would have a census of 20-25 patients in our local community hospital on any given day, and we shared the hospital duties as the “hospital doc” for a week at a time. I truly enjoyed the hospital-based portion of my practice, and this eventually led me to start and build a hospitalist program at our small community hospital. I’ve been a hospitalist ever since and have never looked back.
My story is similar to the experiences of thousands of hospitalists across the country today. Many physicians who entered medical school with the intention of working in an office-based or traditional practice have been drawn into the fast-growing hospital medicine field—where they’ve happily stayed.
Today, according to our best estimates, there are more than 44,000 hospitalists practicing in the U.S. Most have come to the specialty from the internal medicine field, but that is rapidly changing. As the first hospitalist trained in family medicine to serve as SHM president, I couldn’t be more excited or encouraged by the increasing diversity in the types of healthcare practitioners who call themselves hospitalists.
A Changing Profession
Today’s hospitalists come from diverse training environments. In addition to internal medicine, hospitalists are trained in family medicine, pediatrics, intensive care, obstetrics and gynecology, surgery, orthopedics, neurology, oncology, and a variety of other specialties and subspecialties. The specialty hospitalist movement has grown on the back of the same forces that gave a dramatic push to the hospitalist movement over the past 15 years—in-house provider availability, the need for greater inpatient efficiency, the aging physician workforce, and the enormous difficulty of staying competent in both an ambulatory and inpatient setting, just to name a few. Needless to say, it’s become a well-established dynamic with evidence pointing to its long-term benefits for both patients and healthcare delivery systems.
In addition, as demand for hospitalist services continues to grow, hospitals and hospital medicine groups are increasingly adding nurse practitioners (NPs), physician assistants (PAs), and other advanced practice providers to their ranks. According to the 2014 State of Hospital Medicine Report, the use of NPs and PAs in hospital medicine programs serving adults has risen nearly 12% since 2012. Today, more than 65% of hospital medicine groups employ NPs or PAs.
Within SHM, we’re seeing these changes begin to play out in our membership makeup, as well. Though the vast majority of our 14,000 members are internal medicine physicians, more than 10% are hospitalists trained in family medicine (HTFMs), 3% are trained in pediatrics, and 3% are internal medicine/pediatrics. Our fastest growing segments are family medicine and NPs/PAs.
initiatives and educational programs in support of our mission…
Strength in Diversity
The expansion of the hospitalist field to include so many different kinds of providers is beneficial to both SHM and the broader profession.
On a macro level, the increasing diversity of the field has the potential to improve care for hospitalized patients. For example, when more hospital providers are based within the facility, there’s an opportunity for providers to develop improved relationships and communication, which leads to better patient handoffs and expedited care across the inpatient care continuum. Studies have shown that hospitalist practices have a positive impact on patient lengths of stay, readmission rates, and patient satisfaction scores.