When medical doctors Robert Wachter and Lee Goldman coined the phrase ‘hospitalist’ a little more than 20 years ago, the doctors to whom they were referring were a relative rarity. Wachter and Goldman were referring to internists employed by hospitals to handle the most complex cases among patients who either did not have primary care physicians or whose physicians were unable to provide adequate case management. More than two decades later, hospitalist jobs have changed significantly. What’s more, the number of doctors choosing hospitalist work as a profession has grown exponentially.
There were approximately 10,000 hospitalists in the U.S. when the American Hospital Association began keeping records in 2003. Last year there were some 50,000, according to an August 2016 report from Modern Healthcare. At the heart of the exponential increase is the combination of cost-cutting measures and new federal demands to improve the quality of care and increase overall value for patients.
So where does that leave the hospitalist moving forward? By all indications, hospitalist jobs look more attractive than they ever have been. This is true whether you are talking about employed doctors or hospitalist locums working on a contract basis. Hospitalists are playing a more vital role in guaranteeing their hospitalized patients receive the kind of comprehensive care they deserve.
The Orchestra Leader of Medicine
In order to describe what the hospitalist job in the modern era looks like, Modern Healthcare’s Elizabeth Whitman described the hospitalist as the medical equivalent of an orchestra conductor. The conductor himself might actually perform on his violin for just one or two pieces of a concert; most of his time and energy is spent directing the rest of the musicians. The conductor is responsible for coordinating efforts among the orchestra’s members to produce music the audience finds satisfactory.
The hospitalist has much the same role in the modern healthcare setting. Hospitalist jobs do require some direct, hands-on medicine as part of the day-to-day routine, but hospitalists put more effort into ensuring the total compendium of care offered to a patient meets all that patient’s needs.
Whitman cited the example of a patient who might arrive at a local hospital with a broken hip. The hospitalist is the first one to step in to provide care, but the care he/she does provide is limited. He/she must also direct the care provided by an orthopedic surgeon, the nursing staff, and any other specialties that might be involved. The hospitalist must also account for any other health problems the patient may be dealing with at the time.
Complexity Is Part of the Lure
When you consider that the number of hospitalist jobs in America is now about equal to the number of pediatricians currently in practice, it leads to the obvious question of what exactly is luring doctors to hospitalist jobs. There are a number of different factors, one of which is the challenge of being able to work on complex cases.
Hospitalist jobs, whether permanent placement or locum tenens, challenge doctors in ways they would not be challenged working in a primary care setting. The opportunity to manage such complex cases gives hospitalists the opportunity to practice medicine in a very exciting and fulfilling way.
There may be some debate over whether hospitals are becoming too dominant in the primary care arena, but there’s little doubt that hospitalists are providing much-needed services that are improving patient care. There’s no reason to expect the number of hospital jobs to decline in the years ahead. That’s good for both employee doctors and hospitalist locums.