What Is a Hospitalist? - Hospital Medicine Explained

A hospitalist is a physician that specializes in taking care of adult patients that have been admitted to the hospital. This requires the treatment of many different diseases or conditions. Hospitalist medicine is a newly designated area of medical practice that was first described in 1996. Since then it has become a mainstay in hospitals everywhere in the US and has spread to Australia and Canada. The main duties of a hospitalist include:

• Managing the care of adult hospitalized patients.
• Following lab results, ordering medications, and updating medical charts.
• Communicating with patients, nurses, other medical staff and patient's families (either in person or with video teleconferencing technology).
• Ordering consults from other medical specialties.

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1. What are the duties of Hospitalists?
2. What is the educational training for Hospitalists?
3. Hospitalist vs Internal medicine?
4. Do Hospitalists do a Fellowship?
5. Are Hospitalists in every large or community hospital now?
6. Why should prospective Medical students consider becoming a Hospitalist primary care physician?
7. What are the most common professional organizations for Hospitalists?
8. How to pursue a career as a Hospital medicine specialist?

What Exactly Does A Hospitalist Doctor Do?

A Hospitalist serves as a central leader of the medical team that oversees inpatient care services. Hospitalist physicians manage and take care of many conditions on their own such as congestive heart failure, chronic obstructive pulmonary disease exacerbations, type 1 and type 2 diabetes, renal dysfunction and pneumonia. However, they also are involved in communication with other medical service clinicians in cardiology, infectious disease, Pain Management and pulmonary when the patient's health requires more directed care. They also may provide perioperative services. Some patients may require multiple medical services to help with their care and oversee their health. It is the job of the hospitalists to request consults with other medical branches when necessary and coordinate patient care with other specialist doctors. 

A Patient's condition can quickly change throughout their hospital stay. For this reason, hospitalists may continually monitor new test results. Additionally, they are available to answer nurse's questions, meet with patient's family members throughout the day, coordinate care with physical and respiratory therapy, work with dieticians to optimize nutritional meals, suggest the use of helpful vitamins, order follow up tests when necessary and perform patient education to focus on proper physical and mental health. Being a hospital primary care doctor requires 24/7 monitoring of symptoms. Inpatients may need a change in drugs such as Insulin, beta-blockers, a diuretic, therapeutics for an infection, or a special nutrition diet or exercise regimen added. Hospitalists that has chosen to only work overnight shifts are given the title of a Nocturnist.

During the covid-19 pandemic many patients have been seen with all sorts of Medical Conditions related to Covid. The vaccine has definitely helped as the percent of deaths in Covid-19 vaccinated patients has been significantly reduced. January 21, 2022 marks the second anniversary of the first confirmed COVID-19 case in the U.S.

Discover if a career as a hospitalist is right for you.

Learn why 68% of hospitalists would choose the same specialty again.

Hospitalist vs Internal Medicine – what is the difference?

Hospitalists and internists are terms that are frequently interchanged with one another. This is probably due to the fact that internal medicine, which encompasses hospital care, is a more comprehensive field of study.

In point of fact, the great majority of hospitalists start out as internists before specializing in hospital medicine. Although the education and training that internists undertake is broadly comparable to that of hospitalists, the two specialties do not perform identical functions and differ from one another in a variety of other respects.

Internal medicine specialists, on the other hand, see patients in both outpatient and hospital settings, in contrast to hospitalists, who only work in hospitals.

There is also a difference in the length of time that they spend working with their patients. Internists may continue to treat their patients throughout adulthood, which may result in the development of long-term doctor-patient relationship.

On the contrary, hospitalists are physicians who only visit patients during the course of their stay in the hospital. It's possible that the hospitalist will see a patient more frequently if they have a persistent ailment that necessitates many doctor's appointments. However, the overall objective of this profession is not to manage patients on a continuous basis but rather to address the diseases that led to hospitalization.

Does a Hospitalist Have a Medical Degree?

Yes a hospitalist does have an advanced medical degree. Many times people ask how to become a hospitalist physician and the answer is actually quite complex.  Becoming a hospitalist is a very difficult endeavor that requires discipline and many years of education, training, and certification. The first initial step in becoming a hospitalist doctor is getting accepted into medical school. Although not all medical schools require a formal degree, they do require completion of prerequisite courses prior to application. In addition to the required classes, medical applicants must also shadow physicians, volunteer, hold leadership positions, and perform well on the Medical College Admission Test (MCAT) board examination. Each of these steps must be completed by a very rigid publish date to align with certification necessary for application to a school of medicine.  If you are interested in attending medical school to become a hospitalist physician, please research content for admission very carefully.

During medical school, one must pass four board examinations in general medicine on a different publish date for each exam as determined by their medical school. After completion of four years of medical school and certification of a M.D. or D.O degree, one is a doctor but can not yet practice.

Individuals must then secure a spot in a residency which is usually done at a teaching hospital. Residencies provide clinical hands on training in a specific field like internal medicine and prepare individuals for a board certification. Most hospitalist doctors complete a three year residency to internal medicine and are termed internists. Near the end of residency, individuals must pass the internal med board examination by a certain publish date determined by their residency. The practice of hospital medicine may greatly overlap with internal medicine, but hospitalists are not always an internal med doctor. It is important to note however, that individuals that receive board certification in other residencies like family medicine or that are fellowship trained, and specialty trained physicians with careers in intensive care medicine, pulmonology or nephrology may also practice hospital medicine. Upon completion of residency and board exams, individuals are fully trained as an internist and can choose to practice as a hospitalist and secure a job in hospital medicine. In some larger cities where there may be a  pediatric hospital, hospitalists that have received training via a Pediatrics residency can be found and are commonly called Pediatric hospitalists. 

Resources and information about a hospitalist, hospital medicine and their board certification process may be available from different organizations, like the SHM and ACP, and are mentioned in a separate section of this website page.

Do Hospitalists do a Fellowship?

No, most Hospitalists in the US have not completed a Fellowship. This being said, there are now numerous fellowships available for those wanting to pursue a more formal training.  The Society of Hospital Medicine lists 4 types of programs that are available for those wanting to become a Fellow

• Internal medicine route to Hospitalist fellowship
• Family practice route to Hospitalist fellowship
• Pediatric medicine route to Hospitalist fellowship
• Administrative Hospitalist fellowship

Is a Hospitalist Part Of Every Hospital Medical Care Policy Now?

There are many reasons why the niche of hospitalist medicine has persisted and grown to become the standard in most hospitals. Hospitalists allow other medical providers who need to spend time in outpatient clinics the ability to do so by reducing the amount of time spent managing and taking care of patients that need hospitalization. They essentially take the place of an outpatient primary care doctor, but practice only when a patient is in the hospital. This requires hospitalist doctors to have a large breadth of knowledge over many diverse medical conditions that may affect patient's health and care. The area of hospitalist medicine has started to expand outside of primary care into specific populations of patients. Obstetric and surgical and Pediatric hospitalist positions are now emerging in medicine. These hospitalists take care of a specific subset of patients that have unique challenges of treatment.  In addition, overall, hospitalists and nocturnists have become public policy and made a positive difference in caring for patients that are inpatients at a hospital.

Why Would Someone Want to Have A Career In Medicine As A Hospitalist?

Graduating medical school, receiving board certification, and becoming a hospitalist physician is an arduous journey that requires great dedication and years of work and experience. A Hospitalist must attend continuing education events and always continue learning by staying up to date on the meta-analysis from new medical research. The practice of taking care of ill patients can be very rewarding and provide an exceptional income. Individuals that enjoy being in the health care industry and interacting with people would find a good fit in hospital medicine. Hospitalists interact with patients, patient's family and other medical professionals throughout every day. However, the short stay of patients does not always allow a long term relationship to form between doctor and patient.

Additionally, hospital medicine doctors must practice good problem solving and diagnosis skills in order to continuously mediate the large variety of issues of patient care that arise throughout the day.  Many patients have a good recovery back to health with the proper care which can be very rewarding in a career. Most hospitalists physicians work a unique schedule of hours. An example of a hospital physician schedule may include working seven straight days, then taking the following seven days off. This length of working days in a row results in less transferring of patient's care to a different doctor during patient's hospital stay, potentially leading to a quicker return to health and a better physician patient relationship. Overall, hospitalists are a vital workforce component of the medical care system that oversee many patients, manage diverse clinical scenarios, and effectively communicate information between doctors, nurses, technicians and other medical staff. There are also programs available for a Physician assistant that wishes to practice in Hospital medicine

Is There A Website I Can Visit To Learn More About Hospitalists Organizations?

There are many great websites and professional organizations, like the ACP and ABPS, that provide resources and information about hospitalist medicine overall, their practice scope, job duties, board requirements and certification, and the care and rights of patients. These organizations usually have an available membership if interested.

Organizations which have relevant information about hospitalist doctors include:

• American College of Physicians (ACP)

• Society of Hospital Medicine (SMH)

• Society of General Internal Medicine (SGIM)

How to pursue a career as a Hospitalist?

We hope that after reading this blogs article, everyone will have a deeper understanding of Hospital doctors, their education, and the amount of dedication and effort it requires to become one. If you are a prospective Med student and are curious about getting your MD degree at a top rated Caribbean School of Medicine, then please check out our offshore Medical school overview Blog page https://www.umhs-sk.org/caribbean-medical-schools