Hospitalists are medical doctors who work permanently in a hospital, as opposed to primary care physicians, who commute between their medical practices and hospitals to provide patient care. Hospitalists might be trained in general internal medicine or family practice, or they might be specialists in a range of fields that includes obstetrics and gynecology.
My OB/GYN, with whom I’ve formed a comfortable one-on-one relationship, won’t be delivering my baby? It looks as though, in more and more instances, that is the case. However, proponents of the hospitalist trend say that the loss of familiarity with the delivery doctor is a minor inconvenience compared to the security of having somebody at the hospital at all times. (Old-school OB/GYNs remain on call, but it typically takes them some time to reach the hospital.)
Hospitalists, who could be considered stand-ins for the primary care physician, are generally less expensive for hospitals. Furthermore, there is evidence that hospitalists actually improve the state of patient care in general. There have been a number of reports that claim that with hospitalists, hospital stays are reduced by about one day.
And going back to our OB/GYN example, the number of emergency C-sections also tends to be lower when a hospitalist — in this case, a “laborist” — cares for the patient. (The reason for this isn’t really known, but it has been suggested that laborists are more willing to spend time with patients, preventing unnecessary surgeries.)
Growing Demand for Hospitalists
One company that provides hospital staffing, including hospitalists, is Envision Healthcare. Its EmCare subsidiary has been expanding its hospitalist offering to meet growing demand. Other providers who have jumped into the fray include Sheridan Healthcare (acquired by Amsurg Corp. in 2014), Healthcare Partners (a subsidiary of DaVita), and Team Health Holdings. All of these companies have seen growth over the past four years, at least partly because of the industry trend toward using “shift physicians.”
Just how fast is this train going? Hospital medicine has been called the fastest-growing medical specialty these days, with some 48,000 practicing physicians. According to the Society of OB/GYN Hospitalists, there are nearly 250 hospitals in the US that utilize laborists, versus just 10 a decade ago.
The industry is even seeing consolidation: Team Health has struck a deal to acquire fellow hospitalist provider IPC Healthcare for some $1.6 billion. Some speculate that strength in the sector helps these health staffing firms gain leverage with hospitals, and the combination of Team Health and IPC will only help in that arena.
One sector that has felt a negative impact from the hospitalist trend is the pharmaceutical industry. It’s more difficult for a hospitalist to sit down and discuss treatments with pharma sales representatives, as they’ve got unpredictable schedules and, typically, no offices in which to hold meetings. Medical Marketing & Media reports that the hospital sales environment for pharma reps has changed over the past decade, and that is largely due to the elusive hospitalist.
But most of these hospitalists write more than 50 prescriptions weekly. So how does one sell to the inaccessible physician? Sales reps need to adapt to the new environment: Make pitches to hospital staff, get creative in trying to gain access to hospitalists, ask questions to see where urgencies lie.
As previously mentioned, hospitalists have been shown to reduce the length of hospital stays. They also ensure that, in general, patient care is more readily available than it is with traveling physicians. However one feels about the rising use of hospitalists, whether they’re seen as the answer to hospital staffing problems or as an unfortunate development that depersonalizes the doctor-patient relationship, there is no doubt that the train is picking up speed and doesn’t look to be hitting the brakes anytime soon.