Published in the December 2014 issue of Today’s Hospitalist
IN THE EARLY YEARS of hospital medicine, primary care physicians worried that hospitalists would not return their patients after treating them in the hospital. That was more than 10 years ago, and we thought it would be interesting to see exactly where hospitalists’ patients come from “and who hospitalists are handing patients back to. Here’s what we found for full-time adult hospitalists in the 2014 Today’s Hospitalist Compensation & Career Survey.
It’s probably no surprise that unassigned patients make up about one-third of hospitalists’ patients, part of the specialty’s original mission. Nearly half (44%) come from primary care doctors who have contracts with hospitalists, and about one-fifth come from specialists hospitalists work with in comanagement arrangements.
Unassigned patients appear to make up the lowest percent of patients for hospitalists working for multispecialty/primary care groups, with only 23% of hospitalists in this setting saying they treat unassigned patients. Among hospitalists working for universities and medical schools, by comparison, 45% of their patients are unassigned.
In terms of comanagement, orthopedics tops the list, with 85% of hospitalists saying they work with orthopedic surgeons. General surgery is close behind (83%). Other popular specialties for comanagement include cardiology, neurology and GI/hepatology. Even specialties like OB/GYN and psychiatry, which didn’t use to be commonly comanaged by hospitalists, are identified by hospitalists in our survey.
Our data also show that the more years hospitalists have been in the specialty and working at their current jobs, the more likely they are to work with other specialists. While 90% of hospitalists who’ve been in the specialty for 10 years or more comanage orthopedic patients, that’s true for only 71% of hospitalists in the specialty for two years or less.
Finally, how quickly do hospitalists communicate with the physicians to whom they return patients post-hospitalization? Just under two-thirds (60%) say they deliver a discharge summary within 24 hours, while almost one-quarter get a discharge summary to primary care physicians within 48 hours.
By region, 66% of hospitalists in the Pacific region say they turn around discharge summaries within 24 hours. That’s true for only 50% of hospitalists in the Southwest.