By Debra Wood, RN, contributor May 08, 2019
over two decades since it emerged, hospital medicine has transformed the care
of inpatients. Gone are the days that most primary care physicians round on
their patients in the hospital. Now, more than 57,000 hospitalists practice in
the United States.
term hospitalist was coined in a 1996 New
England Journal of Medicine article. Since then, studies have shown
facility-based hospitalists improve efficiency in treating hospital inpatients,
reducing length of stay and readmissions, and increasing patient satisfaction.
The field has also opened up new career options for physicians.
are some of the latest trends, and what can hospitals and hospitalists expect
in the foreseeable future? Here are some key highlights.
locum tenens hospitalist jobs across the U.S., with Staff Care.
10 current trends in
1. Growth in the field
demand for doctors to do that work has exceeded supply, for the whole history
of the field,” said John Nelson, MD, MHM, FACP, with Nelson Flores Hospital
Medicine Consultants in La Quinta, California, and an early hospitalist. “The [hospitalist]
specialty has grown fast.”
continues to believe hospital medicine is a good career choice.
MD, director of perioperative medicine at the Hospital for Special Surgery in
New York City, who manages the hospital’s hospitalists, predicts continued
growth in the field, noting that “hospitalists are not going away.”
hospitals have hospitalists, and the majority of locales struggle to fully
staff their programs, Nelson said. In fact, 9 out of 10 hospitals with more
than 200 beds reported that they have hospitalists in a 2018
report on recruiting incentives by Merritt Hawkins. The firm also reported
a 25 percent increase in the number of client searches to fill hospitalist jobs
over the past year, although the number of searchers is still down from its
peak of three years ago.
authors of the report suggest that the overall change in permanent searches for
hospitalists may be due to increased outsourcing in the temporary (locum tenens)
physician staffing arena.
2. Rising hospitalist salaries
Merritt Hawkins’ report, which looks at starting salaries only, found year-over-year
increases in hospitalist pay, from an average of $229,000 in 2013/2014 to
$269,000 in 2017/2018.
Medscape Hospitalist Compensation Report 2018 reported a range of hospitalist
salaries, from $237,000 annually for pediatrics to $351,000 for anesthesiology.
The Medscape report indicated hospitalists in most fields earn more than their
non-hospitalist colleagues. The exception was in obstetrics/gynecology; however,
their survey found that OB/GYN hospitalists received the largest increase in
salaries at 16 percent last year, followed by anesthesiology hospitalists.
3. More opportunities in
hospitalists can work somewhere other than acute care hospitals. In fact, the Society
for Hospital Medicine’s 2018 report on the state of the field noted
a 25 percent growth in hospitalist jobs in post-acute settings, up from 13
percent in 2016.
These physicians are often referred to as “transitionalists,”
and are most likely to work in one of three post-acute care settings: an
inpatient rehabilitation facility (IRF), a long-term acute-care hospital
(LTACH), or a skilled nursing facility (SNF).
4. Vacancies mean opportunities
for Hospital Medicine reports that two thirds of hospital medical groups had
open positions the previous year, with 12 percent of their hospitalist jobs
are the sixth most-requested specialty in permanent physician searches,
according to Merritt Hawkins. The recruiters at Staff Care also report that
assignments for locum
tenens hospitalists are plentiful.
5. Greater emphasis on
care is becoming the norm in hospital medicine and across the care continuum,
creating a difference in focus for clinicians. Family members can participate
“Today, [families] are considered to be a primary and
essential component of a collaborative approach to patient care,” said John
Loyd, MD, MPH, chief, Division of Neonatology at Dell Children's Hospital/Seton
Hospitals, assistant professor, pediatrics at Dell Medical School in Austin, Texas, and a board member of Hand to Hold, a nonprofit that supports
parents of children in the NICU. “There is a recognition that families are
essential partners in health care.”
6. Frustration with regulations
hospitalists avoid many of the pre-approval authorizations and other
frustrations associated with managed care, hospitalists still must deal with regulations
from Medicare, other insurance carriers and the facility where they work. Some
deal with additional rules from outside companies that manage the hospitalist
group and/or provide the billing and coding. Things like whether a patient is
admitted or staying at the hospital under observation status often put hospital
medicine specialists in a difficult position with patients and families.
Medscape report found the most challenging part of a hospitalist’s job, cited
by 25 percent of respondents, was “having so many rules and regulations.”
half (45 percent) of hospital medicine physicians are internists, according to the
Medscape report, but several specialty physicians, such as pediatric
hospitalists, exist. In fact, Nelson reported nearly all specialties have
Hospital for Special Surgery, the hospitalists provide medical care to
post-operative patients, explained Russell. They care for emergency admissions
and respond to rapid response requests and codes.
Hawkins 2018 white paper on hospitalists reports laborists work in obstetrics
and perform after-hours deliveries. Neuro-hospitalists provide stroke care in
emergency departments, and surgical hospitalists can take the place of
community physicians performing unplanned surgeries. Comprehensivists manage
the care of patients most frequently admitted to the hospital.
8. Easy job transitions
the benefits of hospital medicine is the ease with which physicians can change
are more likely to jump around than doctors in other fields,” Nelson said.
traditional practice, physicians spend years building a referral base and
patient load, he explained. But hospitalists have a built-in patient load, and
when they want to move on, they can easily do so. Hospitalist
jobs are plentiful, and they will find work in another facility.
9. Covering the night shift
who practice during the day must rotate to cover nights. This has given rise to
nocturnists, who choose to work the late night shifts exclusively. Nelson, who
coined the term “nocturnist,” recommends giving these practitioners more days off than regular hospitalists.
Depending on a hospital’s size and patient
population, a nocturnist’s shift can range from quiet to chaotic, as
practitioners generally operate with fewer colleagues and support staff.
Pros and Cons of Working as a Nocturnist
10. Block schedules remain
days on duty and seven days off, with 12-hour days, remains the most common
schedule for hospitalists and often is what attracts physicians to the field.
However, Nelson reports other scheduling approaches can be better for the
physician in the long run, since 12 hours on for seven days in a row can lead to
medicine can provide the work–life balance so many new physicians desire,
especially when they are given the chance to choose their schedules and days
STAFF CARE matches physicians and advanced
practitioners with part-time and full-time locum
tenens assignments across the country, including hospitalist
positions in your choice of specialties.
Contact a Recruiter Now