By Dennis Quick
Senior Staff Writer

In July, the Medical University of South Carolina began a hospitalist program, which now consists of four dedicated hospitalists, each caring for 15 to 20 patients.

Physicians specializing in hospital patient care, hospitalists tend to patients from the time patients are admitted to the time they are discharged. This allows the patient, the patient’s primary care physician and the hospital to enjoy a collective sigh of relief, says Dr. Patrick Cawley, an internist and director of MUSC’s hospitalist services.

“Hospitalists improve the overall efficiency and quality of patient care,” explains Cawley, adding that this ensures patient safety, which in turn can help protect the hospital from lawsuits.

Also, thanks to hospitalists, the patient’s doctor can spend less time making rounds at the hospital and more time caring for patients at the office. And because hospitalists—certified, on-site medical doctors—are always on hand, patients get the care they need faster, shortening their hospital stays and reducing their hospital costs, Cawley claims.

A study conducted by Western Pennsylvania Hospital and the University of Pittsburgh School of Medicine found that hospitalists lowered by 17% the median length of time patients spent hospitalized, according to the Pittsburgh Business Times. Also in the study, the median cost of care for patients tended to by hospitalists compared with patients not tended to by hospitalists was 14% less.  

Although hospitalists arrived on the U.S. medical scene about 20 years ago, it wasn’t until the mid-1990s that their popularity grew. Cawley credits Dr. Robert Wachter, hospitalist program chief at the University of California at San Francisco Medical Center, with coining the term “hospitalist” in 1996. That year, there were a few hundred hospitalists in the United States. Today there are nearly 8,000, and by 2010 there will be 25,000, Wachter estimates.

“Hospitalists are the fastest-growing segment of the medical community,” says Cawley, adding that South Carolina has about 40 hospitalists—a number he says will double within the next five years. Locally, Roper St. Francis Healthcare is considering a hospitalist program. Trident Health System began one about a year and a half ago, according to Cawley.

During the past decade, the hospitalist specialty launched its own professional association and scholarly journal, and has caught the attention of staffing agencies, reports Hospital & Health Networks.

What’s driving the hospitalist phenomenon is the dwindling number of patients primary care physicians are sending to the hospital, explains Cawley. “You’ve got to be really sick to go to the hospital these days,” he points out.

Despite the rapid growth of these programs, hospitalists have yet to be universally accepted by the nation’s medical community. According to Hospital & Health Networks, many family practitioners prefer to make hospital rounds and check on their own patients. Some medical industry experts question whether hospitals are actually saving money with hospitalists or merely shifting the costs to the outpatient sector.

And there are legal questions to resolve. Medical Practice CME.com, an online continuing medical education (CME) service, points out that because hospitalists form a relatively new field, it’s still a toss-up as to who should be held liable for rendering proper care to the patient—the hospitalist or the primary care physician?

Nevertheless, the hospitalist movement is growing to the point where the practice soon will be taught at medical schools, says Cawley. “In the next 10 years there probably will be separate training for hospitalists.”   

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