photo by Lee Ann Yahle The Hospitalist 8 www.oucom.ohio.edu
For nearly 10 years, Robin Thomas, D.O. (‘91), was in private practice in internal medicine. Now, she works 24-hour shifts caring for hospitalized patients–sometimes as many as 20 to 25 a day–at Blanchard Valley Regional Health Center in Findlay, <strong>Ohio</strong>. She misses the close relationships with her private-practice patients, but for her, she’s found a niche in this new role. “I always liked the hospital so much more than the <strong>of</strong>fice, so it was a good fit,” she says. Thomas is among a growing number <strong>of</strong> physicians who have become inpatient care providers in recent years. Hospitalists, as these medical providers <strong>of</strong>ten are called, oversee acute care for hospitalized patients, a role that previously had been the province <strong>of</strong> the primary care physician or specialists. “Hospitalists provide a service to...doctors who <strong>of</strong>ten are too busy with their practices to come to the hospital regularly,” says Jose Torres, D.O. (‘98), who works as a hospitalist at Grandview Hospital/Kettering Medical Center in Dayton, <strong>Ohio</strong>. “Without hospitalists, rounds could go on forever.” The number <strong>of</strong> physicians who oversee acute care in hospitals is growing. by Linda C. Knopp A Movement Takes Root Having physicians on staff to manage inpatient care isn’t a new phenomenon, but it is creating a growing field <strong>of</strong> medicine. In a 1996 New England Journal <strong>of</strong> <strong>Medicine</strong> article, authors Robert Wachter, M.D., and Lee Goldman, M.D., first coined the term “hospitalist” to describe a physician who spends a significant amount <strong>of</strong> work time in hospitals. Today, the Society <strong>of</strong> Hospital <strong>Medicine</strong> (SHM), a Philadelphia-based membership organization for inpatient care providers, defines hospitalists as “physicians whose primary pr<strong>of</strong>essional focus is the general medical care <strong>of</strong> hospitalized patients. Their activities include patient care, teaching, research and leadership related to hospital medicine.” SHM estimates that there are approximately 15,000 practicing hospitalists in the United States today–up from just a few hundred in the late 1990s and no more than a handful in the early ’70s. Even when Thomas completed her internal medicine residency at Akron City Hospital in 1995, most primary care physicians didn’t consider inpatient care a career choice. “At that time, there weren’t many hospitalists,” she says. “Everyone had private practices and did inpatient work. The only physicians with hospital practices were critical care, ER and anesthesia.” Thanks, in part, to increased demands on the time <strong>of</strong> physicians with <strong>of</strong>fice practices, increased pressure from society to provide cost-effective and quality care to hospital inpatients, and limits on the number <strong>of</strong> hours medical residents could work, the field <strong>of</strong> hospital medicine had taken <strong>of</strong>f by 2005 when Eric Schumacher, D.O. (’00), completed his residency in internal medicine and pediatrics at Wright State <strong>University</strong> in Dayton. Because the work schedule and job duties appealed to him, Schumacher accepted a position as a hospitalist at <strong>Ohio</strong> State <strong>University</strong> Medical Center in Columbus, where he cares for patients through the hospital’s general inpatient service, its James Cancer hospitalist service and its Ross Heart hospitalist service. He also cares for hospitalized pediatric patients at Children’s Hospital and serves as an assistant pr<strong>of</strong>essor <strong>of</strong> internal medicine and pediatrics at <strong>Ohio</strong> State. Jose Torres, D.O. (‘98), is among a growing contingent <strong>of</strong> physicians who opt for a hospital-based career. summer 2006 9