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As Population Ages, Field for Hospitalists Growing

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If you’ve ever been in the hospital for very long, chances are that you’ve been tended to by a hospitalist.

Hospitalists — or doctors who work exclusively in hospitals, taking care of admitted patients — are more integrated into today’s medical landscape than ever, as the local population simultaneously increases and ages, illnesses become more complex and hospitals put an unprecedented weight on safety.

“Hospitalists are providers who specialize in the practice of hospital medicine, or internal medicine, with the goal of providing comprehensive medical care to diagnose and manage patients’ acute illnesses while they are hospitalized,” said Susan Brickley Case, senior director of marketing and communications for Howard County General Hospital (HCGH).

“If you are admitted to HCGH, a hospitalist will manage your care, in concert with your primary care physician,” she said. “They also provide hospital care information to patients’ primary care physicians when patients are discharged.”

During the past decade, HCGH has experienced an increase in the number of patients and the complexity of their illnesses. “In recent years, the hospital industry has increased its focus on best practices for patient safety, quality and service,” said Brickley Case. “Hospitalists are critical to providing the best care and experience to patients in the hospital. They manage a patient’s care via an electronic medical record and collaborate with nurses, techs, pharmacists and other specialty physicians to diagnose and treat illness.”

Career Possibilities

Dr. Mindy Kantsiper, medical director with the CIMS Hospitalist’s Practice at HCGH, was a primary care doctor in the community for two decades. When she first became a primary care physician, she expected to be working in inpatient and outpatient environments.

“But it became increasingly impossible to be in two places at once,” said Kantsiper. “I had a yearning to be in the hospital, to be taking care of hospital patients.”

Kantsiper is also what she terms “an academic hospitalist,” meaning in addition to taking care of her own patients and serving shifts in the hospital, she also helps develop high-quality hospitalist programs.

“We develop programs that teach people how to communicate with patient providers and primary care providers.”

Hospitalists are, generally speaking, workers who are also interested in public health and safety, particularly in the growing sector of geriatrics. “We are providing high-quality acute emergency care, in addition to being an extension of primary care,” said Kantsiper.

When she first became a hospitalist, it was rare to have someone say, “‘My dream is to become a hospitalist.’ Not so anymore. Now, we definitely have physicians who come out of residency knowing they want to be hospitalists, the same way they would know they want to do primary care or cardiology.”

Your Hospital Team

You can think of a hospitalist as the “quarterback” of your care team while you’re in the hospital, said Jim Reiter, senior vice president of communications for the Elkridge-based Maryland Hospital Association.

“A hospitalist is a qualified physician who has dedicated their career to hospital medicine and, as such, they coordinate with the patient and his or her family, their primary care doctor and specialists to get patients the care they need,” Reiter said. “Hospitalists work with patients while they’re hospitalized. After discharge, patients return to their primary care doctor.”

Among other duties, hospitalists take thorough medical histories, order tests to monitor and diagnose conditions, prescribe medications and other therapies, and manage a patient’s transition to other care settings or home.

Education has changed to reflect the new field; medical students can now take hospitalist-related electives. “Some medical schools have tracks that emphasize more inpatient than outpatient work after residency,” said Kantsiper. “Those are for folks who might be doing hospitalist-related research.”

Hospitalists, like primary care physicians, also frequently work with nurse practitioners and physician assistants. Though the environment in the hospital can be stressful, Kantsiper said a career as a hospitalist offers a good fit for work-life balance.

“It’s not the only reason to be a hospitalist,” she said, “but one of the things we find is it often provides work-life balance in a way that some other specialties do not.”

Enthusiastic Community

Locally and nationally, the community of hospitalists is growing, and as a body of people they are enthusiastic cheerleaders for their chosen field. New websites, blogs, educational tracks and other outlets indicate that field is strengthening as health care changes across the country.

So strong is the tide for this sector of the health care industry that hospitalist and poet Sima Pendharkar wrote the following on a website encouraging workers to join the ranks.

Starting off the day
In a systematic way
Sifting through the rounding list
Vital signs, data, auscultations and voices
Filtered with care and thought
Stories, smiles, tears and laughter
The colors and sounds
Overwhelm my senses and now back to the chart
Next I make my way, with a careful
dart …

The need for hospitalists will continue to grow, and many people already have been treated by hospitalists without realizing it.

“With how complex and ill our population has become, a lot of people end up coming to the ER,” said Kantsiper. “Fortunately, there are many effective models for hospitalists out there.”