Statistics cited by the Indianapolis Star in a March 2018 article revealed that there were between 400 and 500 hospitalists practicing in the United States in 1996. In the 20+ years since, that number has grown considerably. There are now approximately 57,000 hospitalists and thousands more jobs waiting to be filled.
So what’s behind the huge increase over the last two decades? It’s easy to cite the doctor shortage, but doing so is an oversimplification of a more complex issue. When you peel away the politics and media hype, there are four primary reasons explaining why hospitalists’ numbers keep growing.
1. Private Practice Isn’t What It Used to Be
It used to be that doctors fresh out of residency would return to their hometowns to open a private practice. But private practice is not what it used to be 20 and 30 years ago. A lot has changed since the New England Journal of Medicine first coined the phrase ‘hospitalist’.
Private practice physicians have always been small business owners. But over the last several decades, the business aspect of private practice has swallowed up the medical side of things. Private practice owners now spend more of their time dealing with everything from regulations to insurance company demands and simply paying the bills. They have less time to devote to their patients.
2. Hospitalist Schedules Are Attractive
Working outside the hospital environment leaves doctors open to long hours. Whether a doctor opens his or her own practice or works for a group, there our office hours during the day and on-call at night. A doctor can get worn out pretty quickly if he or she isn’t careful. On the other hand, the hospitalist is in a much better situation.
Hospitalist shifts are almost always set in stone. After all, hospitalists are employees just like nurses and diagnostic technicians. It is fairly common for a hospitalist to work straight 12 hour shifts before punching the clock and going home. And when the hospitalist does go home, there’s no on-call to worry about. There are no business forms to fill out, no estimated taxes to pay, etc.
3. New Doctors Prefer Jobs
Next, data suggests that new doctors prefer jobs rather than practices. It is part of a new mindset that focuses on a good work-life balance rather than building a successful business. More and more, doctors finishing up their residencies view medicine as an occupation rather than a calling. And because it’s an occupation, they are seeking arrangements that offer good pay, reliable schedules, and a range of amenities and benefits. Hospitalist jobs fit the bill.
4. Hospitals Love Their Hospitalists
The fourth and final reason is that hospitals love the hospitalist arrangement. Statistics cited by the Indianapolis Star suggest that utilizing hospitalists decreases operating costs, reduces patient stays, and cuts down on the number of readmissions. All three are important factors in the era of outcome-based medicine.
Hospitals have a vested interest in keeping their own costs down. Reduced costs mean more profit. They also have a vested interest in shortening stays and reducing readmissions. Doing so keeps them in good favor with a federal government that is now tying Medicare and Medicaid payments to length of stay and readmission rates.
There is no arguing that the number of hospitalists practicing in America’s hospitals will continue to rise as time goes on. Some experts even go as far as to suggest the days of private practice are numbered. We could be approaching that day when every doctor’s visit takes place in a hospital or the office of a hospital-owned group.
