Hospital medicine

Hospital medicine is a medical specialty that exists in some countries as a branch of internal medicine, dealing with the care of acutely ill hospitalized patients. Internal physicians whose primary professional focus is caring for hospitalized patients only while they are in the hospital are called hospitalists. Originating in the United States, this type of medical practice has extended into Australia and Canada. The vast majority of physicians who refer to themselves as hospitalists focus their practice upon hospitalized patients, but do not necessarily have separate board certification in hospital medicine. Hospital medicine is a medical specialty that exists in some countries as a branch of internal medicine, dealing with the care of acutely ill hospitalized patients. Internal physicians whose primary professional focus is caring for hospitalized patients only while they are in the hospital are called hospitalists. Originating in the United States, this type of medical practice has extended into Australia and Canada. The vast majority of physicians who refer to themselves as hospitalists focus their practice upon hospitalized patients, but do not necessarily have separate board certification in hospital medicine. The term hospitalist was first coined by Robert Wachter and Lee Goldman in a 1996 New England Journal of Medicine article. The scope of hospital medicine includes acute patient care, teaching, research, and executive leadership related to the delivery of hospital-based care. Hospital medicine, like emergency medicine, is a specialty organized around a site of care (the hospital), rather than an organ (like cardiology), a disease (like oncology), or a patient’s age (like pediatrics). The emergence of hospital medicine in the United States can be compared and contrasted with the parallel development of acute medicine in the United Kingdom, reflecting health system differences. Hospitalists are physicians with a Doctor of Medicine (M.D.), Doctor of Osteopathic Medicine (D.O.), or a Bachelor of Medicine/Bachelor of Surgery (MBBS/MBChB) degree. Contrary to popular belief, most hospitalists practicing in hospitals in the United States lack board certification in hospital medicine. While it was commonly believed that any residency program with a heavy inpatient component provided good hospitalist training, studies have found that general residency training is inadequate because common hospitalist problems like neurology, hospice and palliative care, consultative medicine, and quality improvement tend to be glossed over. To address this, residency programs are starting to develop hospitalist tracks with more tailored education. Several universities have also started fellowship programs specifically geared toward hospital medicine. According to the State of Hospital Medicine Survey by the Medical Group Management Association and the Society of Hospital Medicine, 89.60% of hospitalists specialize in general internal medicine, 5.5% in a pediatrics subspecialty, 3.7% in family practice and 1.2% in internal medicine pediatrics. Data from the survey also reported that 53.5% of hospitalists are employed by hospitals/integrated delivery system and 25.3% are employed by independent hospitalists groups. According to recent data, there are more than 50,000 hospitalists practicing in approximately 75% of U.S. hospitals, including all highly ranked academic medical centers.