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15 Surprising Facts About Hospitalists

During the past couple of decades, hospitalist jobs have taken hold and grown by leaps and bounds. Have you kept up on the latest in the field?

Let’s look at a few interesting facts about hospital medicine in 2020.

1. Hospitalists now have their own day, celebrated each March 

Hospital medicine physicians can now celebrate National Hospitalist Day on the first Thursday in March. This observance was celebrated for the first time in 2019; the day falls on March 5 in 2020.

“It represents the celebration of this widespread MD part of the U.S. health care system,” said Danielle Scheurer, MD, MSCR, president-elect of Society of Hospital Medicine’s board of directors and chief quality officer of the Medical University of South Carolina in Charleston. 

2. The term “hospitalist” was first used nearly a quarter of a century ago 

Robert M. Wachter, MD, and Lee Goldman, MD, both at the University of California, San Francisco, first used the term “hospitalist” in an article in The New England Journal of Medicine in 1996. The article served as an impetus for this developing profession.

3. Hospital medicine is the fastest-growing medical specialty 

From a few hundred hospitalists more than 20 years ago, the field has grown to more than 60,000 physicians who practice hospital medicine in 2020.

“It’s the fastest-growing specialty in the history of medicine,” said John Nelson, MD, MHM, FACP, with Nelson Flores Hospital Medicine Consultants in La Quinta, California, and an early hospitalist.

Scheurer added, “Much of the growth is in response to the increased complexity and shortening length of stay in the hospital system.” While many services have shifted to ambulatory care, she noted that hospitalist jobs are available; the field is “not saturated.”

4. Hospitalists practice in every size hospital

Every U.S. hospital has a hospitalist program, Scheurer said. These practitioners need to know clinical care, but also other factors associated with hospital medicine. 

Nelson added hospitals in larger metropolitan areas and those that graduate residents tend to have adequate hospitalist staffing, but smaller hospitals are still in need of hospital medicine physicians. Demand for hospitalists continues to exceed supply.

5. Hospitalist jobs are in demand 

Nelson reported that hospitalist jobs are in demand, even while most hospital medicine groups employ more hospitalists than they did two years ago. Most groups are expecting to continue adding jobs, as more complex patients are hospitalized.

Merritt Hawkins’ 2019 Review of Physician and Advanced Practitioner Recruiting Incentives reported a 21 percent year-over-year increase in the number of searches for hospitalists.

6. Hospitals aren’t the only employers 

Hospital medicine physicians may be employed by the hospital, a university, or a hospitalist group medical practice.

“The employment model has been shifting to being employed by the hospital, but it varies by site,” Scheurer said. Additionally, staffing companies will contract to guarantee to staff, particularly in rural settings and community access hospitals, she said.

Locum tenens hospitalists are not employees but are independent contractors who are paid by locum staffing companies like AMN Healthcare.

7. Hospitalists tend to be younger physicians, with mixed demographics 

The 2019 Medscape Hospitalist Compensation Report found that 55 percent of hospitalists are aged 35 to 49 years, and 22 percent are younger than 35 years. The age of hospitalists trends is lower than for primary care physicians. Only 3 percent of hospitalists are 65 years or older. The report also showed that the gender breakdown among hospitalists was 40 percent women and 60 percent men.

Asian and Caucasian physicians dominate the racial/ethnic mix among hospitalists, with 37 percent and 36 percent respectively. Hispanics represent 8 percent, blacks 5 percent, and mixed-race 4 percent.

8.  Two-thirds of hospitalists are satisfied with their compensation 

The 2019 Medscape report indicated hospitalists earn an average of $242,000 annually. Eighty-six percent of hospitalists receive professional liability coverage. Most also receive health, dental and vision insurance, and a retirement plan with an employer match. Sixty-five percent report feeling they are compensated fairly.

9. Hospital medicine can be a good first step for new physicians 

Physicians must complete a residency prior to becoming a hospitalist.

“If you learned what you were supposed to as a resident, you should have a sufficient knowledge base to perform as a hospitalist,” Nelson said.

“The upfront investment is low, and you are not building a practice,” Scheurer said. “You come into a full flight of patients on Day One.”

10. Hospital medicine can be a short-term or long-term career 

Hospitalist jobs can be short-term, as newly minted physicians figure out what they want to do with their lives, Scheurer said. And some physicians choose it as a long-term career.

Physicians who would like to try out different facilities and locations may opt for locum tenens hospitalist positions; these temporary assignments can sometimes open doors for long-term jobs, as well.

11. Some freedoms are unique to locum tenens hospitalists 

Locum tenens hospitalist assignments offer opportunities to work part-time in your local area or full-time as a travel assignment. Clinicians get to choose when and where they work, and their locum agency will assist with job placements, licensing and credentialing, relocation, and reimbursements for housing and travel expenses.

12. Nearly 4 out of 5 hospitalists are internists 

Most hospitalists (79 percent) specialize in internal medicine, per the Medscape compensation survey, followed by 20 percent in family medicine and 1 percent in pediatrics.

Physicians trained in obstetrics, neurology, surgery, or other specialties may choose to care for patients with those conditions exclusively in a hospital setting, Nelson explained.

According to the 2018 State of Hospital Medicine Report, published biennially by the Society of Hospital Medicine, 25 percent of hospitalist groups are now performing work in post-acute settings.

13. Hospital medicine groups often use block schedules 

Many hospitalists work seven 12-hour days on duty followed by seven days off, but the profession is trying to put into place more research-based practices, Scheurer said.

Some groups schedule nocturnists to consistently work the overnight shifts. Otherwise, hospitalists in the group will rotate to cover night shifts. 

14. Variety and patient acuity among most satisfying aspects of hospitalist jobs 

Nelson indicated that many hospitalists enjoy caring for acutely ill patients rather than managing patients’ chronic conditions over the long term, as with primary care.

“It’s an ever-changing, fast-paced environment,” Scheurer said. “Every day is different, it’s never boring and very little downtime.”

Additionally, hospital medicine is team-based and highly interactive. Hospitalists usually have fixed shifts, which means they don’t have to be on call, Nelson added.

Being good at their job was cited as most rewarding by 27 percent of hospitalist respondents to the Medscape survey, followed by gratitude and relationships with patients.

Among the most dissatisfying aspects of their job, the report noted that the number of rules and regulations topped the list of hospitalists’ challenges, cited by 30 percent, followed closely by dealing with difficult patients at 28 percent.

15. Career paths are available in hospital medicine 

Nearly half (48 percent) of hospitalists surveyed for the Medscape report expressed an interest in being promoted. More women than men hospitalists seek upward career opportunities. Front-line physicians practicing hospital medicine in 2020 can become practice administrators or accept a leadership position at a hospital or in academia.

“There seems to be a growing trend of hospitalists taking on some portion of their life in administrative roles,” Scheurer said.

AMN Healthcare places locum tenens hospitalists and other clinicians in top facilities around the U.S.

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