The forces driving the hospitalist movement are varied and disparate in origin. One major force is primary care physicians. When uninterrupted by calls from and visits to the hospital, physicians realize greater productivity and predictability in the office and can concentrate on caring for increasingly ill outpatients, some of whom would have to have been hospitalized only a few years ago. In addition, as hospitalized patients have, on average, become sicker and thus present a more complex diagnostic and therapeutic challenge, many primary care physicians, who typically have only one to three patients in the hospital at any one time, are becoming more and more uncomfortable about managing the care of these often seriously ill patients, especially from a remote location. As a result, support for the hospitalist movement among primary care physicians is growing.
Hospitals are another force behind the hospitalist movement.
The use of hospitalists enables a hospital to admit patients referred by outpatient physicians who opt not to practice in the hospital, patients it might once have lost to a more accommodating competitor. Managed care organizations have also contributed to the emergence of the hospitalist movement. 4 Benefits Development of the acute care skills and expertise needed to treat today s hospitalized patients, who have graver, more complex medical problems than did yesterday s inpatients, is one of the many benefits offered by hospitalist systems. Unlike outpatient physicians, hospital-based physicians can see inpatients multiple times a day if needed and can more readily attend family conferences and impromptu family meetings. Since hospitalists spend more time in the hospital than their outpatient colleagues, they have enhanced knowledge of the strengths and interests of various subspecialists and surgeons, which allows them to guide patient referrals appropriately.