What is a “hospitalist”? A hospitalist is a physician who specializes in the care of patients while they are in the hospital. The term “hospitalist” was first used in the New England Journal of Medicine in 1996 to describe physicians who spend most of their time caring for patients who are in the hospital as opposed to physicians who only visit their own patients when they are in the hospital.
In the United States, the only recognized national professional association of hospitalists is the Society of Hospital Medicine (“SHM”), which has a membership of approximately 10,000 hospitalists. There are about 31,000 hospitalists practicing in 4 out of 5 hospitals throughout the United States, which number is expected to reach 40,000 in the next few years. The SHM defines a hospitalist as “A physician who specializes in the practice of hospital medicine.”
According to the SHM, hospitalists coordinate hospital care of patients with their primary care physicians (“PCP”) and are involved with patient care from the time of their admission into the hospital until they are discharged from the hospital. Hospitalists see hospital patients throughout the day, they are part of a team of physicians, and they coordinate patient care in the hospital. After a patient’s discharge from the hospital, hospitalists update the PCP regarding necessary care and refer the patient back to the PCP. Hospitalists are trained in the same manner as PCPs and typically complete their residencies in internal medicine.
The percentage of physicians in general internal medicine who were identified as hospitalists increased from 5.9% in 1995 to 19.0% in 2006, and the odds of receiving care from a hospitalist increased by 29.2% per year from 1997 through 2006. A 2007–2008 survey of hospitalists found that only 1.1% of their total encounters were with outpatients and only 0.9% were with patients in the emergency room, leading to the conclusion that the vast majority of hospitalists devote their time almost exclusively to the care of hospitalized patients.
The Doctors Company, the largest medical malpractice insurer in the United States, has about 3,000 hospitalists among the 46,000 physicians it insures for malpractice. It began underwriting, rating, and tracking hospitalists as a specific group only in 2009 (medical malpractice claims historically are tracked by medical specialty as opposed to care setting, which resulted in medical malpractice claims against hospitalists being assigned as internal medicine or family practice claims).
The Doctors Company reports that the number of hospitalists named in medical malpractice claims has been increasing despite the overall number of medical malpractice claims decreasing. The most prevalent claims against hospitalists involve acute heart attacks and strokes, often due to alleged misdiagnosis or late diagnosis that may result from the hospitalist believing that a specialist is in charge of the patient’s care and the specialist believing that the hospitalist is in charge of the patient’s care.
With regard to the issue of co-management of a hospitalized patient’s care by specialists and by hospitalists, a senior representative of The Doctors Company has stated, “The important thing about co-management is that if it’s done correctly, it does not increase anyone’s liability. If it’s done poorly, it increases everyone’s liability.”
If you or a loved one may have been injured as a result of the medical negligence of a hospitalist, you should promptly consult with a local medical malpractice attorney who may investigate the hospitalist negligence claim for you and file a hospitalist medical malpractice claim on your behalf, if appropriate.
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