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


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


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]

hra "the growing role of hospitalists"

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