Hospital medicine

Hospital medicine is a medical specialty that exists in some countries as a branch of family medicine or internal medicine, dealing with the care of acutely ill hospitalized patients. Physicians whose primary professional focus is caring for hospitalized patients only while they are in the hospital are called hospitalists. Originating in the United States, this type of medical practice has extended into Australia and Canada. The vast majority of physicians who refer to themselves as hospitalists focus their practice upon hospitalized patients. Hospitalists are not necessarily required to have separate board certification in hospital medicine. The term hospitalist was first coined by Robert Wachter and Lee Goldman in a 1996 New England Journal of Medicine article. The scope of hospital medicine includes acute patient care, teaching, research, and executive leadership related to the delivery of hospital-based care. Hospital medicine, like emergency medicine, is a specialty organized around the location of care (the hospital), rather than an organ (like cardiology), disease (like oncology), or a patient’s age (like pediatrics). The emergence of hospital medicine in the United States can be compared and contrasted with the parallel development of acute medicine in the United Kingdom, reflecting health system differences. In the US, a typical hospitalist workday in the hospital lasts roughly 10 hours, arriving around 7AM and taking care of a "census" of 14 to 18 patients. Hospitalists typically embrace the rhythm of a "7 on 7 off" schedule, starting each 7-day stretch on a Tuesday and ending on a Monday. While these are typical, what counts as a normal workday, census, and shift schedule can vary from hospital to hospital. A hospitalist is like a football quarterback, a central node coordinating patient care for hospitalized inpatients for the duration of their stay. Compared to other medical specialties, hospitalists must work more closely with a much broader range of other healthcare professionals, such as specialist physicians, bedside nurses, charge nurses, pharmacists, and case managers.