“This is exciting because it’s someone who helped define policy,” Shank says. “This is someone who knows the inside of it. He’s been in the room for discussions that will affect hospitalists for years down the road.”
Exactly what those effects will be will take time to understand. But Dr. Kocher sees reform as a chance for HM to make itself indispensable to hospitals looking to improve quality, efficiency, and transitional-care outcomes.
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The responsibility will, of course, come with the challenge of actually proving that HM can deliver on the pledge of better care at better prices.
“For hospitals, as the payment system evolves and matures, we’re going to be paying more often for outcomes,” Dr. Kocher says. “That change is going to require hospitalists to become much more reliable.
“It’s a more specialized skill that doctors who are part-time hospital doctors are going to have a hard time developing. It clearly makes the system more dependent on hospitalists. … That said, I think that it’s the responsibility of hospitalists to prove they can deliver.”
Dr. Kocher is optimistic that the political squabbling the reform process has sparked will have little lasting impact. He understands HM leaders might be nervous about the potential for political upheaval to translate into medical upheaval, but he doubts that will happen.
“The political rhetoric and scuffling going on in Washington has almost no bearing on the fundamental underlying trend which will drive the market to near-universal use of hospitalists,” he says. “Whether you’re a Republican or Democrat, you share the perspective that the current health system is wildly too expensive.” HM11
Richard Quinn is a freelance writer based in New Jersey.