Hospitalists and their role

A drastic change has been exhibited in the U.S healthcare sector where hospitalists have been incorporated in the service delivery. According to Sultz (2006), most healthcare institutions have included physician hospitalists in service delivery to assist in providing personalized care to the outpatients as well as the hospitalized patients. The emerging specialty of the hospitalists under the existing U.S.A healthcare system has enhanced efficiency, streamlined as well as cost effective procedures in service delivery among individuals seeking medical services in various healthcare institutions. More often than not, the hospitalists are charged with the task of managing the patient affairs, taking and maintaining their records for follow-up purposes. Hospitalists are normally involved in patients' admission tasks or even patient care scheduling procedures. It is a common belief that the hospitalists work at flexible hours.

Nevertheless due to the current upsurge which has been witnessed in a bid to adopt the hospitalists programs, there have been instances where staff have being overworked especially during instance where they are required to provide attendance services to several patients. As a result, hospitalists tend to report low performance levels. Due to the current upsurge on the need for hospitalists in U.S.A, there are many approaches which have been employed to organize the hospitalists. There are hospitalists who are trained as generalists while others exist as specialists. Inclusion of specialists in the hospital operations assist in improving on expertise in general management and control of the inpatient care sector as expertise is generally improved. Hospitalists assist the hospital staff, specialty consultants as well as outpatient physicians. This is advantageous to the physicians who are attached to the outpatient physicians as they are able to dedicate more time attending to various patients and engaging in other hospital roles. The services of the hospitalists are preferred because unlike the primary care physicians who spend relatively short duration attending to patients, hospitalists are able to spend considerable amount of time in providing quality inpatient care. Nonetheless, there may be instances when the patients would prefer to be attended to by the primary care specialists. Such patients are those in the intensive care unit as well as those suffering from intense illnesses as AIDS, coronary syndromes and other chronic illnesses (Miller, 2008).

It is required that the good communication exists between the hospitalists and the primary care physicians. Such established rapport helps in building positive procedure when attending to patients needs. When good communication exists, then continuous medication process prevails such that care and service given to the patients will be ensured thus increasing the general quality of our healthcare system. Even though the hospitalists contribute positively to service delivery in the hospitals, there are concerns that lack of communication hampers the output or performance levels of such staff. It is thus important for an optimal job description to be developed for the hospitalists prior to hiring procedures. According to Kongstvedt (2007), whenever the care of a patient is transferred to the hospitalists, it is paramount that meticulous communication is undertaken between the patient, the patient's physician as well as the hospitalist so as to avert occurrences of unresolved patient issues. There are instances when operations of the hospitalists are hampered by arising conflict of interest between hospital's primary care providers and the trained hospitalist. Such situation arises where care providers use the opportunity to attend to hospitalized patients in building their skills as primary healthcare providers. Despite this setback, it is vital to note that most hospitals in the U.S do not require the care of the hospitalized patients to be solely undertaken by physicians. The primary care physicians as well as the hospitalists can monitor the progress of any patient when proper records relating to patient's progress and medication procedures are kept.

Hospitalists are usually hired when any hospital experiences unplanned human capital shortages where patients' figures outnumber the available practitioners. Such transfers would require quality participation from the hospitalists. The waiting time is drastically reduced when the services of the hospitalist are employed (Wachter et al, 2005). Giving the hospitalists the mandate to work together with other physicians offers them better exposure in medical operations. For example, team is able to divide the work effectively putting such factors as acuity, urgency as well as the geographical location of the patients into consideration. Similarly, hospitalists are deliberately prepared for higher rank when serving in the observational units as the medical directors thus improving the quality of the healthcare provided. This means the time taken to address the requirement of any patient is reduced be it on admission, discharge or change of drugs incase such patients are not responding to the treatment they receive.

Before the hospitalists begin providing their services, it is expected that they are given some form of training so as to ensure that important skills like reviewing the history of the patients as well as making prescriptions is done in the right way (Perkin et al, 2007). This helps in boosting the confidence of the patients on quality of the service they are receiving. Sometimes, the primary care providers may reexamine the patients who had earlier on been examined by the hospitalists so as to ensure the right diagnosis is made. Most patients who require services from hospitalists are those who have been operated-on and they possibly require postoperative care. In addition, the experience which the hospitalists have gathered during their interactions with the patients enables them to provide these services. A case to point is the attendance care offered to patients who have chronic heart failure. Most of the hospitalists have interacted with such patients and it is very easy to identify such risky developments in the sickness like fluid overload. A hospitalist is preferred by such patients because they receive total care at all times.

It is expected that in order to ensure the success on integration of hospitalists program, into health care system it is paramount that all the hospital officials are consulted so that a smooth transition is achieved when the hospitalists are delegated management duties. The established Primary Care Physicians (i.e. PCPs) also need to be consulted before embarking on the program. While it may be viewed as a cost saving strategy to employ the hospitalists, the hospitalists attract high salaries due to the increased demand of their services as witnessed in U.S healthcare division (Sultz, 2006). Much of these remuneration issues have been instigated by the dire need for hospitalists' care and the perceived quality of services offered to both outpatient and inpatient in various healthcare institutions. Most notably, there has been the issue of the ever increasing demand for hospitalists as a contingency measure to poor relationship between the normal primary care-givers, and those patients requiring quality time with trained hospitalist during recovery.

In conclusion, there are instances when the hospitalists are given similar remuneration as the physicians who were employed in traditional service. It is also expected that the tasks which the hospitalists are assigned to undertake are not limited to certain activities since no patient has a problem which is narrowly defined. The hospitalists need to handle all the medical issues since they are qualified professionals who have completed their medical training in their distinctive areas. It's also crucial to regularly review hospitalists' packages regularly as an attempt to avoid high rates of turnover. For example, hospitalists ought to be allotted duties based on various areas such as internal medicine, pediatrics as well as family practice, and align such responsibilities to revised remunerations. Finally, hospital's administrators should have realistic expectations on what the hospitalists can offer. When newly employed, the hospitalists should be given time to adjust and handle the stipulated tasks based on their basis of recruitment.


Kongstvedt, R. (2007). Essentials of managed health care. Sudbury, MA: Jones&Barlett Publishers

Miller, J. (2008). Hospitalists: A guide to building and sustaining a successful program. Chicago, IL: Health Administration Press.

Perkin R, Swift, D., & Newton A. (2007). Pediatric hospital medicine: textbook of inpatient management. Baltimore, MD: Lippincott Williams &Wilkins publishers.

Young, K., Siegler E, & Foust, J. (2006). An introduction to hospitals and inpatient care. London, UK: Springer publishing company.

Wachter, R, Goldman, L. & Hollander, H (2005). Hospital medicine. Baltimore, MD: Lippincott Williams& Wilkins publishers.

Sultz, A. (2006). Health care USA: understanding its organization and delivery. New York, U.S.A: Jones &Bartlett Publishers.

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