What Is A Hospitalist? | AUA
What Is A Hospitalist? | AUA

Hospitalists engage in a variety of tasks that are vitally important to providing general medical care in hospital settings, but their extensive role in the healthcare system remains relatively unknown to the general public.  

Hospitalists are a type of physician who specializes in the inpatient care of hospitalized patients. As a relatively new branch of specialized medicine, the role of hospitalists continues to evolve. They engage in a wide variety of activities in hospitals, including inpatient care, teaching, research and leadership roles, with the goal of improving hospital performance and patient outcomes. 

Hospitalist History

Reaching back only to 1996, the term “hospitalist” was first coined in an article in the New England Journal of Medicine, written by Robert Wachter, MD, MHM. As this new area of focus rose to prominence in the medical field, it did not take long for the hospitalist model to demonstrate its effectiveness. 

In response, the Society of Hospital Medicine was founded the following year, in 1997, and studies quickly began showing that hospitalist physicians were effective at reducing costs for hospitals and lengths of stay for hospital patients, while improving quality of care and patient outcomes. 

What is the Difference Between a Doctor and a Hospitalist?

A hospitalist is a doctor that specializes in hospital operations, and also helps coordinate between the various stakeholders involved in patient care. 

Unlike other medical specialists, hospitalists focus on the site of care (i.e. the hospital), rather than a particular type of care, system of the body or specific population. 

Hospitalists assist with the continuum of hospital care by following patients and working with internal stakeholders to improve patient outcomes and operational efficiency. 

What Exactly Does a Hospitalist do?

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With the increasing complexity of modern medical care, the role of hospitalists will only become more important over time. 

The hospitalist approach was developed to address several challenging issues faced by hospital managers and physicians alike due to the increasing complexity of hospital care for adult patients, such as the need for improved convenience, safety and efficiency for patients, better coordination for specialized care and increased cost-effectiveness for hospitals. 

Through this approach, hospital medicine specialists provide evidence-based insight into the nature of care in modern hospital settings and how to improve hospital patient outcomes. 

On a day-to-day basis, the practice of hospital medicine includes:

  • Managing the care of adult hospitalized patients
  • Following test results, ordering medications, and updating medical charts
  • Communicating with patients, patient’s families, and medical staff
  • Ordering consults from other medical specialties

Are Hospitalists Trained in Internal Medicine?

Although you don’t have to be an internal medicine specialist to become a hospitalist, a background in internal medicine is a common precondition to a career in hospital medicine. As a result, many hospitalists come from a background of general internal medicine. 

Helping Improve Hospital Medicine

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Hospitalist medicine specialists are essential to improving important areas of hospital care such as patient safety, medical error reduction, and hospital cost effectiveness.

Hospitalists improve the inpatient care of hospitalized patients by creating a comprehensive plan for their care during their hospital stay and are the point of contact for other doctors and nurses for questions and updates. They are also the primary care doctor for family members to contact for updates. 

The Benefits of Hospitalist in Medical Environments

On top of the important functions listed above, the hospitalist approach also helps with:

Treating Unassigned Patients

Hospitalists allow primary care physicians to focus their time and attention on their office patients by facilitating the hospital admission of many patients.

Reducing Length of Hospital Stay 

Studies have consistently shown that hospitalists are effective at reducing hospital stay duration and hospital costs. 

Hospital Leadership & Administration

More and more hospitalists are being tapped for leadership positions in hospitals because they are uniquely qualified to understand health care challenges and propose solutions. For the same reason, many hospitalist doctors also move into roles as hospital administrators. 

Improving Patient Safety and Quality of Care 

Hospitalists are constantly striving to improve the quality and efficiency of care in their hospitals. Their long-term efforts to reduce medical errors in a hospital setting have led to new ways of thinking about how to develop a holistic hospital medicine approach.

Supporting Family Physicians

Unlike your primary care doctor, a hospitalist will always be on hand if you need to go to the hospital. By working closely with staff, hospitalists can address concerns as they arise, communicate important information to patients and their loved ones, recommend treatment options, order lab tests and prescribe medication. 

Employment for Hospitalists

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For most hospitalists, the focus of their professional efforts is to collaborate and communicate with other doctors and stakeholders. They help provide a continuum of patient care by acting as a liaison between the primary care physician, specialists, and nurses. This important aspect of hospital medicine helps ensure continuity between inpatient and ambulatory settings to improve patient outcomes.   

In addition to clinical work, hospitalists are also employed in other roles. Academic medical centers and teaching hospitals usually have medical students and internal medicine residents rotating on hospitalist-directed services. 

Hospitalists take on research roles that may focus on treatment of specific diseases, care delivery models, inpatient care quality improvement, and general medical education. 

Hospitalists are also uniquely qualified to participate in or lead important hospital programs such as quality and patient safety initiatives, as well as in hospital administration, such as medical directorships and leadership positions in medical organizations.

The Path to Becoming a Hospitalist

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Becoming a hospitalist requires many years of education, training, and certification. 

The first step in becoming a hospitalist is getting accepted into medical school. From there, individuals must secure medical residency training. 

Most hospitalist medicine specialists complete a three year-residency in internal medicine to become internists. Near the end of residency, individuals must pass the internal medicine board examination by a certain publish date determined by their residency. 

The practice of hospital medicine may greatly overlap with internal medicine, which is why so many hospitalists were initially internists. But hospitalists are not always an internal medicine doctor. Individuals that receive board certification in other residencies or fellowships, like family medicine, intensive care medicine, or pulmonology, may also practice hospital medicine. 

Upon completion of residency and board exams, doctors are fully trained hospitalists and may secure a job in hospital medicine.



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