Hospitalists

Hospital medicine in the United States is the medical specialty concerned with the care of acutely ill hospitalized patients. Physicians whose primary professional focus is caring for hospitalized patients only while they are in the hospital are called hospitalists. This type of medical practice has extended beyond the US into Canada.

The term hospitalist was first coined by Robert Wachter and Lee Goldman in a 1996 New England Journal of Medicine article. The scope of hospital medicine includes acute patient care, teaching, research, and executive leadership related to the delivery of hospital-based care. Hospital medicine, like emergency medicine, is a specialty organized around a site of care (the hospital), rather than an organ (like cardiology), a disease (like oncology), or a patient’s age (like pediatrics). The emergence of hospital medicine has both similarities with and differences from acute medicine in the United Kingdom, reflecting health system differences.

Hospitalists are physicians with a Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.) degree. While it was commonly believed that any residency program with a heavy inpatient component provided good hospitalist training, studies have found that general residency training is inadequate because common hospitalist problems like neurology, hospice and palliative care, consultative medicine, and quality improvement tend to be glossed over. To address this, residency programs are starting to develop hospitalist tracks with more tailored education. Several universities have also started fellowship programs specifically geared toward hospital medicine.

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