Download - HRA "The Growing Role of Hospitalists"
The Growing
Importance of Hospitalists
With guest speakerJohn Fani Srour, MDInstructor in Medicine
Harvard Medical School
Department of Internal Medicine
Hospital Medicine Program at Beth Israel Deaconess Medical Center
Boston
presents…
Growing Importance of the Hospitalists• PCPs are much less involved in inpatient care• Super specialists• Overcrowded ERs/hospitals• Increased cost pressures on hospitals/practices • Sicker and older patients • Complex hospital systems (committees,
administration)• 24h (in house) MD availability• Medical errors
Growing Importance of the Hospitalists (cont’d)
• 2003 survey: 39% of the 813,248 community hospital beds are at hospitals with HM Groups
• 2003 survey: 51% of teaching hospitals have hospitalists
• Near future: all except small hospitals (teaching and non teaching) will have hospitalists
Growing Number of Hospitalists
0
5000
10000
15000
20000
25000
30000
35000
GeneralSurgery
Cardiology InfectiousDisease
Critical Care Geriatrics Hospitalist2000
Hospitalists2006
Hospitalists2010
Lurie, Am J Med, 1999
Number of U.S. Physicians
What Do Hospitalists Do?
Inpatient care
Outpatient care
Teaching
Research
Administration
Quality/Performanceimprovement
Training Required • Medical School• 3 years of internal medicine residency training
(some programs have hospital medicine tract included in the 3 yrs)
• Some do 1 year of GIM fellowship (mostly research)
• ABIM moving forward with “Focused Recognition in Hospital Medicine”
• SHM recognition: FHM, SFHM, etc
Hospitalists’ Specialties• General IM only 82%• Subspecialty IM 4% (Nephrology, ID, etc)
TOTAL Internal Medicine 86%• Pediatric Training 9% (Pediatric Hospitalist)• Internal Medicine-Pediatrics 2%• Family Practice 3%
Involvement in Patient Care • Hospital Care• Peri-Operative Care• Palliative Care• Critical Care• Quality Improvement• Hospital Committees including pharmacy
committees
Hospital Care/Types of Medical Cases We Handle • Pneumonia• Acute heart failure• COPD/emphysema exacerbation• Pulmonary embolism/DVT• Gastrointestinal bleeding• Acute asthma• Diabetic complications
• Acute stroke and related complications• Cellulitis and soft tissues infections• Pyelonephritits (UTIs)• Altered mental status/delirium • Chest pains including myocardial infarctions• Abdominal pain • Acute and chronic pancreatitis, cholecystitis, and
biliary disease• AND THE LIST IS ENDLESS…..
Hospital Care/Types of Medical Cases We Handle (cont’d)
Influence in Drug Utilization Policies
• Most hospitalist are involved in committees including hospital pharmacy committees
• Hospitalists treat with medications versus surgery or procedures.
• Compliance with guidelines or pathways for diseases’ treatments and drug utilization
Medications We Use…• Antibiotics• Anticoagulants (blood thinners)• Heart medications (diuretics, blood pressure
medications, cholesterol lowering agents, etc.)• Steroids• Pulmonary medications
Our Challenges • High expectations• Cost reduction• Reduce LOS• Provide measurable QI• Standards & Compliance• Uncompensated care• Committee service/administration
Dilip Phadnis - Director, New Product Development, HRA
Hospitalists—A syndicated study now available from HRA Research
Comprehensive and in-depth studyBased on two focus groups, 200 questionnaire responses, internal search and thought leader interviews
Hospitalists—A syndicated study now available from HRA Research
Contact Your HRA Representative Today to Inquire About the Hospitalist Study:
Jeff Chase 973-240-1216 [email protected] Goveia 973-240-1219 [email protected] Giordano 973-240-1205 [email protected] Longo 973-240-1192 [email protected] Steinbock 973-240-1215 [email protected]
Tips for Pharmaceutical Representatives • Hospital Medicine is the fastest growing specialty
in the U.S• Most hospitalists are in committees and/or
leadership positions including pharmacy committees, systems improvement, case management, utilization review, and clinical operations as pertains to hospital setting
• Hospitalists are seen as a possible solution to the current health care crisis and they have strong influence on hospitals’ decision making
How and when to reach any hospitalists
• Clinical work: one week on and one week off
• Week off: - Vacation- Research- Administration - Best way: email (hospitals’ website), call
administrator, email program director
Hospitalists—A syndicated study now available from HRA Research
Contact Your HRA Representative Today to Inquire About the Hospitalist Study:
Jeff Chase 973-240-1216 [email protected] Goveia 973-240-1219 [email protected] Giordano 973-240-1205 [email protected] Longo 973-240-1192 [email protected] Steinbock 973-240-1215 [email protected]