New Recruits, New Paths
Larry Spratling, MD, chief medical officer at Banner Baywood Medical Center in Mesa, Ariz., expects to see even more changes to the career trajectory of hospitalists. A pulmonary-disease specialist by training, he believes that as the payment systems are reformed to reward the quality of treatment, many more hospitalists will find their careers outside the walls of institutions.
Theoretically, improved outcomes that reduce readmissions would equate to fewer overall patients, potentially requiring fewer hospitalists in the future. The recent proliferation of hospitalists in long-term acute-care hospitals (LTACs), rehabilitation centers, skilled-nursing facilities (SNFs), and other facilities likely will continue that trend, as HM practitioners adapt to the needs of what Dr. Spratling calls "hospital space in a new system." Dr. Spratling goes as far as to wonder if the specialty's skill set might even presage a new name, perhaps something like acute-care medical specialists.
"The acute-care management skills that they have in the hospital, we can use them in these other sites of care," he adds. "They aren't just limited to the hospital anymore."
Another angle of career development is career inception, so newly minted by SHM president Eric Howell, MD, SFHM. In fact, Dr. Howell made recruitment of the next generation of hospitalists and HM leaders a major plank of his one-year term. Of the society's 12,000 members, just 500 are medical students and house staff members. He'd like to triple that figure by HM14.
He believes that the same professional and personal factors that have swelled the specialty's ranks to some 40,000 practitioners will appeal to younger physicians. On the clinical side, that includes a focus on QI at a time when health care is being pushed to be better and a chance to be a leader in the hospital of the future. On a positive note, Dr. Howell, chief of hospital medicine at Johns Hopkins Bayview Medical Center in Baltimore, says hospitalists continue to see their compensation rise along with good work-life balance.
"For our specialty to be just as powerful, and just as important, and thrive just as much in the next 16 years as it has in the past 16 years, we are going to need high-quality recruits—and a lot of them," Dr. Howell says.