The hospitalist is the doctor specializing in the branch of medicine known as hospital medicine.In other words, he is the specialist who cares for patients with severe, long-term or ICU-severity stays at the facility. Its an emotionally charged, physically demanding profession, but numerous hospitalists find it rewarding and stimulating.
It is historically a short-term branch of medical service; turn-over and burn-out in the profession can be severe, even for those prepared for the demanding nature of the work. However, it is a step to specialization also, and numerous hospitalists have gone on to careers in specialized medicine.
In essence, the hospitalist acts as a liaison between initial doctor referrals and specialist treatments. For instance, a patient comes in and sees their regular doctor for a serious complaint; the doctor diagnoses a severe condition, and refers the patient to a specialist. Or there may be a traumatic accidental occurrence that brings the patient to a hospital bed. In either case, before the specialist can arrive, the liaison is the doctor taking care of the patient to bring him/her through immediate emergency status.
One is also a case manager in this particular field, as a number of patients may be seen in the course of a day, and all will need liaison services to transition them to the physician of record. Thus, this particular profession is a demanding one, requiring concentration, emotional stability and a good deal of medical knowledge, especially in the field of emergency treatments and triage.
How does one enter this profession? The vast majority of these in-between doctors are already physicians, with either an Osteopathic Medicine degree (an O.M.) or a Doctor of Medicine (M.D.) classification. Naturally, anyone wishing to obtain that degree begins with a long and arduous training in pre-med and medical school. The most rigorous training for potential M.D. candidates includes thousands of hours (the minimum, in this competitive job market, is 4000) in internship training at various medical facilities.
The trouble is that, for a specialist in hospital medicine, such training is never enough. General residency avoids or skims over common problems that the liaison doctor will face in, for example, neurologist paradigms, as well as hospice/palliative care and quality assurance. Some residency programs have specialized tracks of training for this particular profession, and numerous universities have fellowships designed specifically for the liaison doctor.
These professionals make up the most rapidly growing medical paradigm in the US medical field. It evolved because of the great need for emergency and intensive care and the development and maintenance of the ICU, a specialized hospital setting that was unheard of fifty years ago.The training is especially rigorous, and usually one can look forward to up to 2000 hours of additional training in hospital specializations to enter the profession.In all, 6000 residency hours are usually expected as preparation for a professional in this field.
The number of jobs in this particular profession has grown immensely in the period from 2006 to 2010; it has single leveled off somewhat, although the market is very active still in this particular field. On average, a hospital liaison of this nature makes between $200K and $250K annually, with specialists in night shifts receiving even higher wages and benefits.
The latter is one reason some physicians are reluctant to act as emergency liaisons; in addition to the specialized care that is required, the rigorous training and the emotional stresses, the liaison doctor must be available 24 hours a day, and the shifts are generally three full 24 hour periods on, three off.For an internist this is punishing enough; for an adult specialist, it feels a bit like returning to the exhausting days of pre-medical training.
Rewarding? Yes. But the professional hospitalist has not only a great deal of training but a great deal of stress in his/her life, and it is certainly not work for everyonenot even for every doctor.