Where hospitalists come from
. . . and how they do it
Facilities have instituted hospitalist programs with various configurations over the past few years, but the basics remain the same for the practitioner: Once a patient comes through the door, the hospitalist has total control of the acute care episode and manages that care until discharge.
Sometimes a hospitalist comes out of a large multispecialty group practice that designates one of its newer, younger physicians to follow its hospital cases. The designated doctor typically is just out of residency and tends to know the climate of the hospital better than an internist who’s been in office practice a few years.
As hospitalists gain ground, hospitalist-only groups are springing up. "I prefer in-hospital practice," says John R. Nelson, MD, an internist and hospitalist in Gainesville, FL. "It’s very difficult perhaps impossible to stay good at both office and hospital practice. There’s too much to keep abreast of."
Hospital Peer Review asked Nelson if managed care created a need for hospitalists. "Not so," he answered. "Hospitals and third-party payers are a driving force behind the rapid proliferation of the movement, but they had nothing to do with its creation. This was going to happen anyway. Before the term managed care was widely used, in the mid- to late 80s, our Gainesville group was gearing up."
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