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JAMA Patient Page
June 4, 2014

Hospital Medicine and Hospitalists

JAMA. 2014;311(21):2246. doi:10.1001/jama.2014.1679

Hospital medicine is a field of medicine that is dedicated to providing patients with high-quality care during their hospital stay.

Hospital medicine is the fastest-growing medical specialty in the United States. Doctors who practice hospital medicine are called hospitalists. Hospitalists are usually trained in internal medicine, pediatrics, or family medicine.

The Era of Hospital Medicine

In the past, when a patient was admitted to the hospital, that patient’s primary care physician (PCP) would also take care of him or her every day in the hospital. However, it was often difficult for PCPs to see both their regularly scheduled clinic patients as well as their hospitalized patients every day. As a result, hospitals started hiring hospitalists, doctors who take care of patients only while they are in the hospital. These doctors do not see patients in clinics or outpatient offices. In hospitals where there are hospitalists, PCPs usually provide care for their patients only outside of the hospital.

Benefits of Having Hospitalists

Hospitalists are specially trained to work in a hospital setting. Unlike PCPs, hospitalists are usually physically in the hospital when they are working. Therefore, they are more available than PCPs and can respond more quickly to issues that arise during hospitalization.

Hospitalists also have special skill sets that can benefit hospitalized patients.

  • They generally know the hospital system well and are able to effectively coordinate care with specialists and consultants.

  • They are experienced with setting up care transitions such as skilled nursing home transfers if needed.

  • They are experienced in performing many inpatient medical procedures.

  • They are dedicated to maximizing the quality of care in the hospital and are often involved in research and teaching activities in this regard.

Downsides of Having Hospitalists

The biggest downside to the hospital medicine model is that unlike PCPs, hospitalists do not know their patients’ medical histories when they are first admitted to the hospital. Hospitalists have to go through a detailed history with their patients, which can be time consuming. But hospitalists will often talk to a patient’s PCP for background information. Another potential downside is follow-up after discharge from the hospital. If a patient’s PCP is not involved during the patient’s hospital stay, the PCP can find out what happened only through medical records or the patient’s own account, both of which are not as ideal as being present firsthand.

The bottom line is that there should always be an open line of communication between a patient’s PCP and hospitalist.

What You Can Do as a Patient

If you are admitted to the hospital under the care of a hospitalist, there are some things you can do to make your hospital stay as smooth as possible.

  • Have the name and contact information for your PCP and give it to your hospitalist when you are first admitted to the hospital.

  • Bring a complete and current medication list with you, even if your PCP is in the same hospital network, because sometimes the lists in the system are not up to date.

  • If possible, call your PCP yourself to let him or her know you are in the hospital. Often, this can make the communication between your PCP and your hospitalist easier to establish.

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For More Information

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA’s website at jama.com. Many are available in English and Spanish.

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Article Information
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.

Source: Society of Hospital Medicine

Topic: Health Care Delivery

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