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New recommendations target hospitalist shortage

May 2008

Published in the May 2008 issue of Today’s Hospitalist

Internal medicine remains flat in the Match

THE NUMBER OF MEDICAL STUDENTS choosing a residency in internal medicine remained relatively flat compared to last year’s results. A total of 2,680 medical students chose a first-year position in internal medicine, a drop of 20 students from 2007.

Officials from the American College of Physicians warned that the results are a harbinger of an upcoming shortage of general internists and other primary care physicians. About half of all medical students who match to internal medicine go on to subspecialize.

There was better news for primary care from family medicine, which saw a 7.2% increase in the number of matches over last year. In part, that trend was due to the increased number of family medicine positions this year.

Other popular specialties included plastic surgery, orthopedic surgery, dermatology, otolaryngology, diagnostic radiology, radiation oncology and general surgery.

This year’s Match, held on March 20, was the largest ever, with nearly 29,000 applicants vying for 22,240 first-year positions. More than one-fifth of all those positions were in internal medicine

In this year’s Match, more than 10,300 applicants earned their medical degree outside of the U.S. (About half matched to a first-year position.) In addition, nearly 1,900 osteopathic students and graduates applied to the Match this year.

More information on the Match is available online.

Think tank targets productivity to solve hospitalist shortage

A THINK TANK made up of leaders from the nation’s largest private hospital medicine groups has issued recommendations to mitigate the specialty’s physician shortage.

The Phoenix Group released a white paper focusing on how the shortage is playing out in hospital medicine’s “unbridled growth.” Predictions that hospitalist ranks may double within five years don’t seem achievable, the paper states, given the fact that the current hospitalist workforce of 20,000 “may well be close to a peak.”

Instead, the paper states, hospitalists need to find ways to augment their numbers and improve productivity.

To boost productivity, the group recommends that physicians be able to hand off administrative duties to personnel such as care coordinators and to design schedules, compensation and technology to improve workflow.

Other recommendations include:

“¢ recruiting family physicians and DOs;
“¢ stepping up efforts to train and recruit midlevels;
“¢ advocating for faster state licensing; and
“¢ lobbying for changes in visa laws to allow more IMGs to practice in the U.S.

The white paper is online.

Hospitals see mixed results in new patient satisfaction scores

PRELIMINARY PATIENT SATISFACTION SCORES recently posted online find most people more or less happy with a recent hospital stay, but plenty of room for improvement.

Patients from 2,500 hospitals were asked to answer 22 questions on topics like communication, pain management and hospital noise levels. The questions applied to a hospital visit between October 2006 and June 2007.

Three in five patients said they were extremely satisfied with their hospital care, but 21% of patients said their physician didn’t do a good job of communicating with them, and more than 25% of patients said the same thing about nurses.

Information was collected as part of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, which is administered by the federal government.

Participation in this round of surveys was optional for hospitals, but starting this July, hospitals that don’t participate face a 2% cut in their Medicare inpatient reimbursements. The Centers for Medicare and Medicaid Services expects just under 4,000 hospitals to take part in the survey process this year.

More details of the survey are available on the Hospital Compare Web site.

THE CENTER TO ADVANCE PALLIATIVE CARE released the following data on palliative care programs in U.S. hospitals:

  • 31% of U.S. hospitals now have such programs. That represents 1,299 hospitals, up from only 632 in 2000.
  • 47% of U.S. hospitals with more than 50 beds have a palliative care service.
  • 77% of hospitals that have more than 250 beds have such a program.