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June 9, 2010

Trends in US Physician Work Hours—Reply

JAMA. 2010;303(22):2250-2251. doi:10.1001/jama.2010.732

In Reply: Dr Chmelik raises a concern regarding whether our analysis may have incorrectly classified the increasing number of hospitalists as residents. While this will be a growing concern as the number of hospitalists increases in the future, some rough calculations suggest that the number of hospitalists misclassified in our data was small.

Based on a median age of 37 years, nearly half of the estimated 13 000 hospitalists in 20061 could be under age 35 years. However, our definition of residents was based on the physician's employer being a hospital, and data from the Society of Hospital Medicine suggest that only 34% of hospitalists were employed by hospitals in 2005, with most hospitalists employed in some form of group practice.2 Thus, the total number of hospitalists younger than 35 years employed by hospitals is likely to be small: 34% of one-half of 13 000, or approximately 2000. This number is consistent with an estimate from the 2007 AMA Physician Masterfile of fewer than 3000 nonresident hospital-based physicians younger than 35 years,3 which was the basis for the statement in our article that “97% of hospital-based physicians younger than 35 years were residents.”

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