What is a hospitalist?

Quite simply, a hospitalist is a physician who specializes in hospital care. He or she evaluates hospitalized patients each day, decide whether they are sick enough for admission and order their release. A hospitalist orders tests, explains the results to the patient and family members, writes orders for nurses and troubleshoots any problems that arise in caring for a sick patient.

When hospitalized patients need care from several types of physicians, hospital care specialists coordinate it. They create treatment plans and serve as the point of contact for other doctors. In general, they remove the need for an admitting physician to visit the patient every day.

Many hospitals contract for inpatient specialists much as they do for emergency medicine specialists in the ER. Under this arrangement, a group practice provides doctors to the hospital. The doctors typically bill a patient's health insurance separately from the hospital's charges.

Some patients become upset when they find out that they will not see their primary care doctors in the hospital. However, knowing what a hospital care specialist does before needing one can help reduce patient anxiety

Hospitalist training and certification

Hospital care specialists have earned a Doctor of Medicine (M.D.) or a Doctor of Osteopathic Medicine (D.O.) credential. In larger hospitals, they might teach or do research in addition to providing patient care, depending upon their particular training.

Most of these doctors have had the same training as specialists in internal medicine. Some are specialists in such areas as pulmonology whose personal preference is to work in a hospital instead of an office practice setting.

A hospital specialist must complete a four-year college degree, followed by four years of study at an accredited medical school. He or she must then complete at least a one-year internship and a three-year residency, and pass all three parts of the United States Medical Licensing Exam (USMLE).

Licensing also requires passing the respective exam for each state. Many hospitals require that the doctor be certified by the American Board of Internal Medicine.

Some doctors opt to seek certification in hospital medicine from the American Board of Hospital Medicine (ABHM). The ABHM also has a program for general internists who practice in a hospital. It allows them to earn and keep certification in internal medicine with a Focused Practice in Hospital Medicine credential.

Hospitals with these specialists on staff usually offer them many opportunities for continuing education.

Why hospitals use hospitalists

The hospital care specialist movement arose in the late 1990s to cut the cost of caring for hospitalized patients. Early practitioners were responsible for reducing the length of patient stays, cutting treatment costs, generally increasing treatment efficiency and safeguarding patients from hospital-acquired diseases. Currently, around 30,000 hospitalists are now working. A study by the New England Journal of Medicine revealed that using these specialists reduced the cost of an average hospital stay by 12 percent, or roughly half a day off a typical patient visit of four days.

The role of personal and primary care physicians in the care of admitted patients has quickly shrunk. Many of these physicians have realized that using hospital specialists frees them to generate increased revenue in the office. Sometimes hospital officials task these specialists with developing, streamlining and managing areas such as quality assurance and patient intake. In residency programs with a hospital care track, students learn about the business and operations of medicine.

Most hospital specialists work a block schedule, which helps hospitals deal with programs that curtail the hours that residents can work. The specialists have more expertise than other providers in treating complicated cases on a day-to-day basis. They are also on the premises most of the day to provide information to family members and other doctors, and to re-examine a patient, if necessary.

Critics believe that hospital care specialists probably do not know a patient's medical history nearly as well as a primary care physician. Additionally, personal physicians sometimes have problems getting access to the results of hospital tests, procedures, medications and treatment.

If you find that you're in need of a hospital stay, check out the hospitalists and hospitals in your area. You can get background on hospitalists' education, continuing education and accepted insurance plans by consulting Angie's List, where you can also see reviews and rankings from other members' experiences. 

Get help from a patient advocate

When you're a hospital patient, your primary focus is on getting well. But you may not know what questions to ask to ensure you're getting the best care. Patient advocates can help you make sure you're not overlooking any important information before you receive treatment. Some can even help you dispute charges you may not have incurred. 

Read more in the Angie's List Guide to Patient Advocates.

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