Evolution of Hospital Medicine and the Impact on Residents’ Career Choices

Excerpt

Since its inception in the 1990s, the practice of hospital medicine has grown rapidly and is considered the fastest growing specialty in the history of medicine.1 The initial impetus for developing hospital medicine was to localize clinical practice to the in-patient setting to improve the efficiency of care, and these efficiency gains have been demonstrated by reductions in length of stay and total hospital costs.2 ^, 3 The next phase in the evolution of hospitalist practice has focused on improving the overall value of care, with value being defined as the quality of care divided by the cost.4 The common inpatient quality measures that hospitalists can influence include readmissions, patient safety and patient satisfaction. To further improve the overall value of in-patient care, many programs are testing new models of care delivery, such as adjusting provider schedules, incorporating advanced practitioners, and localizing hospitalist teams to specific nursing units. As the field of hospital medicine matures, it is important to understand how these new models of care delivery may influence internal medicine resident career choices. …