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Hospital Medicine Carves Out Niches


 

A recent study looking at how hospitalists impact the cost of the care in the hospital drives home that point. The study, demonstrated that when hospitalists managed inpatients, the average length of stay was shorter and hospital costs were less. But in the month after discharge, Medicare costs and readmissions were higher (Ann. Intern. Med. 2011;155:152-9).

"The main lesson for the other specialties adopting the hospitalist model is, ‘don’t be in such a hurry to pat yourself on the back,’ " Dr. Nelson said. "Wait for some proof."

But while Dr. Nelson said the study is important and should not be dismissed, he also noted that even with the extra costs associated with care by a hospitalist, there isn’t another model out there for solving the problem of finding doctors to care for patients in the hospital.

Aside from costs and quality, it remains to be seen exactly how the addition of hospitalists from other specialties will impact the relationship between physicians in and out of the hospital, how it will affect career longevity in these specialties, and if it could change how hospitals credential physicians, Dr. Nelson said.

Many of these questions will be addressed in November when the Society of Hospital Medicine convenes a one-day meeting in Las Vegas to look at the trends in the specialization of the hospital medicine field. The meeting, which is being organized by Dr. Nelson, will include presentations on the lessons learned in the first 15 years of hospital medicine and the return on investment from these programs.

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