Home From The Editor Coping with hospital medicine’s success

Coping with hospital medicine’s success

September 2009

Published in the September 2009 issue of Today’s Hospitalist

OVER THE YEARS, one of the most interesting things about following hospital medicine has been the chance to watch a group of relatively young physicians cope with their own success.

Ten years ago, for example, few could have predicted just how in demand hospitalists would be. At times, it seems hard to believe how quickly hospitalists have expanded not only their scope of practice, but their power within U.S. hospitals.

But the specialty’s spectacular growth has some downsides. Individual hospitalist programs, for example, have always had problems keeping up with a seemingly endless demand for their services.

With many hospitalists being asked to admit everyone but the most emergent surgical patients, some find themselves in the uncomfortable position of having to say “no” to other specialties and to hospital administrators. And as hospitalists take charge of complex quality and safety initiatives, physicians are having to dig deep to tap management skills they didn’t know they had.

All of this is putting tremendous pressure on the current crop of hospitalist leaders. As our story on page 28 points out, the physician who was a perfect fit to lead a start-up group may not be the best person to advance that same practice as a sophisticated business.

No one is blaming these physicians. Hospitalists, after all, receive little to no training for these roles and instead learn most of their management skills on the job.

With a number of serious challenges on the horizon “from health care reform and cost containment to swine flu “one thing is certain: Leading a hospitalist program will only get harder. The question, then, is how many hospitalists will feel they’re up to that task.

edoyleEdward Doyle
Editor and Publisher
edoyle@todayshospitalist.com