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What it takes to be a hospitalist

Keywords: A hospitalist considers the evolution of his specialty

by Edward Doyle

Published in the August 2009 issue of Today's Hospitalist

What exactly is a hospitalist? For years, hospitalists have taken great pains to note that they are much more than internists who happen to work only in the hospital. (My apologies to pediatricians and family physicians in the audience, but this was the way the debate was framed in the old days.) The specialty has always defined itself not so much by where its physicians work, but the kind of work they do.

In this monthís issue, a hospitalist expands on that line of thinking and explains why he doesnít consider himself to be an internist at all. As the author points out in the commentary, he may have been trained in internal medicine but now heís a hospitalist. As such, his work diverges substantially from a traditional internal medicine practice.

Iím not sure how mainstream his view is, but itís an interesting example of how the specialtyís identity may be changing. Another can be found in this monthís cover story, which looks at how hospitalist groups in some markets have become so saturated that those programs are no longer looking for new recruits.

Thatís news because it means that, for the first time in the specialtyís brief history, hospitalists in some parts of the country may have real trouble finding work. But the story also points to changes in what it means to be a hospitalist, at least one who can find a job in these very competitive markets.

One program director quoted in the story, for example, said he regularly hears from private practice internists who want to close their office and opt instead for the lifestyle and income of a hospitalist. Once upon a time, they would have gotten his attention, but no more. For him, the kind of communication and leadership skills that only experienced hospitalists have developed trumps specialty training every time.

Edward Doyle
Editor and Publisher

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