Skip to main content
Sister Publication Links
  • ESG: THE IMPLEMENTATION IMPERATIVE
Subscribe
  • Sign Up Free
  • Login
  • Subscribe
  • News
    • Current News
    • Providers
    • Insurance
    • Digital Health
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Transformation
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Unwell in America
  • Opinion
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Diversity in Healthcare
      • - Luminaries
      • - Top 25 Diversity Leaders
      • - Leaders to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Digital Health Transformation Summit
    • ESG: The Implementation Imperative Summit
    • Leadership Symposium
    • Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Diversity Leaders Gala
    • Top 25 Women Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Hospital at Home
    • - Workplace of the Future
    • - Digital Health
    • - Future of Staffing
    • - Hospital of the Future (Fall)
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
  • Data Center
    • Data Center Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • MORE+
    • Contact Us
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Providers
August 11, 2016 01:00 AM

After 20 years, what's next for hospitalists?

Elizabeth Whitman
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print
    “There are people talking about how we can eventually close down all the hospitals,” said Dr. Bob Wachter, who helped coin the term hospitalist. “That's not going to happen.”

    When the idea of a hospitalist—a doctor, usually an internist, based in the hospital and specializing in caring for patients with complex cases—first emerged 20 years ago, it was considered novel, even fringe. Today, hospitalists in the U.S. rival pediatricians in number and have developed into an essential field in healthcare.

    As hospitalists have found their place in the medical world, however, fresh questions and challenges have emerged. Two Perspectives in the New England Journal of Medicine this month, one of them by the two doctors who coined the term hospitalist, Dr. Robert Wachter and Dr. Lee Goldman, examined the specialty's ascendance and its future role in an ever-evolving healthcare landscape.

    “Although we continue to believe that the hospitalist model is the best guarantor of high-quality, efficient inpatient care, it's clear that today's pressures require innovative approaches around this core,” Wachter, of the University of California, San Francisco, and Goldman, of Columbia University, wrote.

    The other Perspective, by Dr. Richard Gunderman of the Indiana University School of Medicine, questioned the impact of hospital medicine on healthcare overall. “The acute-care focus of hospital medicine may not match the need of many patients for effective disease prevention and health promotion,” he wrote. “I suspect the inherent tensions will remain fundamentally irresolvable.”

    These questions emerge amid a growing emphasis in medicine on coordinated, integrated care. And while in many ways a hospitalist's job is to provide precisely that, some see the growing reliance on them as indicative of healthcare becoming too hospital-centric, in a way that hinders comprehensive care.

    “What we don't yet know sufficiently well is the impact of the rise of hospital medicine on overall health status, total costs, and the well-being of patients and physicians,” Grunderman wrote.

    If a 70-year-old patient comes into a hospital with a fractured hip and in need of orthopedic surgery, the hospitalist would manage that patient's treatment by taking into account not just the injured joint but any other comorbidities that an elderly patient might have, such as heart failure that increases their risk of a blood clot. A common metaphor for a hospitalist is an orchestra conductor or a ship's captain, ensuring the harmonious and efficient delivery of medical care.

    In 2003, when the American Hospital Association first began tracking the specialty, the U.S. had slightly more than 10,000 hospitalists. In 2016, the country had more than 50,000, an increase driven by both economic necessity and a spate of government changes that emphasized efficiency and quality in healthcare. The field's boom is showing no signs of slowing.

    “We're seeing many medical students start medical school saying. 'I want to be a hospitalist,'” Wachter said. Indeed, hospitalists will remain vital to the healthcare system even as the industry tilts toward population health, he added.

    “There are people talking about how we can eventually close down all the hospitals,” Wachter said. “That's not going to happen.”

    Today, patients that end up in the hospital tend to be even sicker, presenting with even more complex cases than previously, making doctors who specialize in handling these types of patients ever more necessary.

    The challenge now for hospitalists is not so much in staying relevant but in remaining innovative and in continuing to deliver better care, especially as they are tasked with more diverse responsibilities. In recent years, hospitals looking for ways to improve efficiencies and lower costs, have begun outsourcing hospitalists. That's led some hospitalists to raise concerns about being spread to thin.

    “What we're seeing is an expansion of the scope of hospitalists,” said Dr. Larry Wellikson, the CEO of the Society of Hospital Medicine. “We're being asked to do critical-care medicine. We're being asked to go out and manage nursing home care.”

    Hospitalists do not merely aim to provide seamless, high-quality care for patients in hospitals. Their focus on integrated, managed care has also put them at the vanguard of the biggest systemic shifts in healthcare. But after 20 years, hospitalists will have to work to maintain that momentum.

    “We're now a mature, really important field,” said Wachter. “That's my biggest worry: that we'll become old and staid and rest on our laurels.”

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    health care_doc and patient_i.jpg
    Michigan primary care doctors want more funding to help rural staffing shortages
    BurnoutUnsplash.jpg
    Health systems bet on employee mental health initiatives
    Most Popular
    1
    More healthcare organizations at risk of credit default, Moody's says
    2
    Centene fills out senior executive team with new president, COO
    3
    SCAN, CareOregon plan to merge into the HealthRight Group
    4
    Blue Cross Blue Shield of Michigan unveils big push that lets physicians take on risk, reap rewards
    5
    Bright Health weighs reverse stock split as delisting looms
    Sponsored Content
    Modern Healthcare A.M. Newsletter: Sign up to receive a comprehensive weekday morning newsletter designed for busy healthcare executives who need the latest and most important healthcare news and analysis.
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2023. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • Providers
      • Insurance
      • Digital Health
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Unwell in America
    • Opinion
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • ESG: The Implementation Imperative Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Hospital at Home
        • - Workplace of the Future
        • - Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • Data Center
      • Data Center Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • MORE+
      • Contact Us
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing