Is the hospitalist movement merely a way station in the evolution of the U.S. healthcare delivery system, or is it here to stay?
Robert Kaplan and George Mack, both of Torrey Pines Health Group in San Diego, think that using hospitalists could end the service breakdowns that sometimes plague hospitals.
They'll explain the whys and wherefores of this development at 10: 30 a.m. and 2: 15 p.m. Tuesday, March 28.
Many patients who go to the emergency department don't have a physician at the hospital. This and the fact that hospital administrators were having trouble getting physicians to take calls were the starting points of the hospitalist idea, Kaplan says.
Also contributing to the need for hospitalists are the facts that patients are sometimes admitted because there is no one to evaluate them and attending physicians may respond too slowly. "That's what we mean by the continuum (of care) breakdowns," Kaplan says.
Hospitalists also can smooth over communication breakdowns that occur when patients are discharged from the hospital and transferred to nursing homes or other settings.
Kaplan and Mack will talk about the results of a survey of hospitalists they recently completed. The hospitalist movement seems to be growing, they say.
"At some places that have adopted them, they have full-time hospitalists working 24/7, and they're employees of the hospital," Kaplan says.
Most hospitalists are employed by hospitals, with medical groups taking second place and managed-care organizations third.
The National Association of Inpatient Physicians has 2,000 members, and about 3,200 hospitalists are believed to be practicing in the U.S.
The concept seems to be working so well in hospitals that some hospitalists are branching into the skilled-nursing setting, Kaplan says.