Wednesday, May 25, 2005

Internal Medicine "Hospitalist" Residencies

MD Redux posted on what he perceives as a certain futility to "hospitalist" residency tracks. His position is that internal medicine residencies already focus on inpatient care.

As a hospitalist myself, I feel that his point is well taken. In fact, I would suggest that one of the most important qualities for a prospective hospitalist is to be as skilled at outpatient medicine as possible.

Why? Because being intimately aware of how patients actually live in the real (outpatient) world gives great insight as to how (and when) a patient can be effectively discharged. Such skill will reduce lengths of stay (and admission rates). Being skilled in outpatient medicine also gives valuable insight into creating successful discharge plans and knowing what will work and what won't. Patient satisfaction would be expected to go up as would outcomes. "Bounce-backs" (re-admissions) would be kept to a minimum.

I always counsel our IM residents who've expressed interest in becoming hospitalists to pay close attention to their ambulatory medicine rotations as well as their rotations in the ED and urgent care.

I don't necessarily believe that there needs to be specific hospitalist tracks. I do however believe that hospitalist curriculae may be of benefit in teaching the "hospitalist" way of thinking. There is a unique body of knowledge relevant to the practice of inpatient medicine. But I think this knowledge is better imparted with a lecture series and syllabus than by a formal three year training program.


Blogger Internal Medicine Doctor said...

another way for them to take advantage of us you say?

more free labor

May 25, 2005 10:05 AM  
Blogger The Medicine Man said...

Mad House Madman,

No one is suggesting three more years of training in addition to a traditional IM residency!

A hospitalist track would simply be an option for people looking for an IM program who plan on becoming hospitalists. This is analogous to the many residency programs that have specific primary care tracks for people who don't plan on doing subspecialties.


May 25, 2005 3:52 PM  

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