The University of Massachusetts Medical School, seeking to bolster the number of minority physicians in Massachusetts, plans to offer high school seniors the opportunity to gain admission to college and medical school at the same time. Under the initiative, the state's only public medical school will partner with UMass campuses in Boston, Amherst, Lowell, and Dartmouth to create a joint baccalaureate-MD program that would ensure admission for aspiring doctors from underrepresented ethnic and socioeconomic groups.
Hospital leaders in the C-suite support hospitalist program growth, according to a recent study, "California hospital leaders' views of hospitalists: Meeting needs of the present and future," which was published in the Journal of Hospital Medicine.
As hospitalists take on more roles in the hospital, rotating between the inpatient, emergency, and surgery floors, hospital leaders also support additional training for these physicians.
The study surveyed hospital leaders—CEOs, COOs, CMOs, vice presidents of medical affairs, and medical directors—at 179 nonfederal, acute hospitals in California in 2006-2007. More than half (57%) expected hospitalist program growth during the next two years, according to the study.
And at hospitals without existing programs, 44% of hospital leaders planned to implement one within the next two years. None of the respondents planned to cut the size of their hospitalist groups.
With 25,000 hospitalists in the U.S., hospital medicine is the fastest growing medical specialty.
What is the catalyst for this boom? Whereas startup reasons used to be about cost containment, hospital administrators are now more interested in initiatives of quality and patient coverage.
"The C-suite has an interest in improving the quality of care. They're responding to the transparency movements of public metrics for CMS, The Joint Commission, for the public setting," said lead author of the study, Dr. Eduard Vasilevskis, MD, associate professor of medicine and staff physician at Vanderbilt Center for Health Services Research in Nashville. "They see hospitalists as a solution toward improving quality of care in the hospital."
For institutions with existing programs, leaders implemented hospitalist programs to meet patient coverage (68% of respondents), improve costs and length of stay (63%), and improve ED throughput (62%), according to the study.
For hospitals that planned on starting programs, leaders said they were going to implement hospitalist programs within the next two years for quality improvement (54%) and demand for primary care doctors (46%).
A moving target definition
As they make their way onto different department floors, defining what a typical hospitalist does may become challenging, according to the study.
"Hospitalists are doing a lot of different things in the hospital. In addition to the standard inpatient ward care, they are doing surgical comanagement, quality improvement activities, safety activities, ER staffing and triaging; they are doing a lot of things in addition to caring for inpatients," Vasilevskis said.
The study defined hospitalist, simply put, as a "physician who spends all or the majority of his or her clinical, administrative, educational, or research activities in the care of hospitalized patients."
Last month, the Society of Hospital Medicine released its official definition of a hospitalist as a "physician who specializes in the practice of hospital medicine. Following medical school, hospitalists typically undergo residency training in general internal medicine, general pediatrics, or family practice, but may also receive training in other medical disciplines."
According to Vasilevskis, the definition of a hospitalist depends on the place of practice in which he or she fulfills the needs and creates the job description.
Supporting extra training
As hospitalists expand the hats they wear and the roles they play, more of these physicians may require additional training or certification to work beyond their traditional comfort zone of the inpatient ward and more in the ICU and ED.
"Certification might be worth while," Vasilevskis said. "Hospitalists can provide and fulfill the skills that hospitals are seeking, and whether a hospitalist seeks those additional skills requires that matching between what a hospital wants and what do hospitalists have to offer."
According to the study, most leaders (64%) support extra training or certification for hospitalists.
"The good news is there is someone a) who is there to fulfill that need and b) someone who is willing to respond to that need," Vasilevskis said. "It's a nice marriage of what the C-suite is responding to and having the personnel to do it."
Karen M. Cheung is an associate editor for HCPro, contributing writer for HealthLeaders Media, and blogger for HospitalistLeadership.com. She can be contacted at kcheung@hcpro.com.
House Speaker Nancy Pelosi has eliminated the most obvious avenue for completing healthcare reform, saying the House will not embrace the version of the legislation already approved by the Senate, the Washington Post reports. Pelosi had struggled to sell the Senate legislation to reluctant Democrats since Republican Scott Brown's upset victory in the Massachusetts Senate election cost Democrats their filibuster-proof Senate majority. House approval of the Senate package would have delivered the bill quickly to the president's desk, reports the Post.
Passage of a comprehensive healthcare reform bill looked impossible after the Democrats' loss of a Senate seat in Massachusetts. As an alternative, lawmakers in both parties said, some pieces of the bills already passed by the House and the Senate could be pulled out and packaged together in a measure that would command broad support, the New York Times reports. The consensus measure would be less ambitious than the bills approved last year. It would extend insurance coverage to perhaps 12 million to 15 million people.
A majority of Americans say President Obama and congressional Democrats should suspend work on the healthcare bill that has been on the verge of passage and consider alternatives that would draw more Republican support, a USA Today/Gallup Poll finds. Those surveyed are inclined to say Obama and Democratic leaders have erred in making healthcare the top legislative priority for now. Forty-six percent say that healthcare is important but that there are other problems they should address first; 19% say healthcare should not be a major priority.
Consumer groups, patient advocates, and doctors have called on Democrats not to abandon the comprehensive health overhaul they have worked so long to pass. "The legislation passed by the House and Senate would broaden access to quality, affordable healthcare to tens of millions of people who are currently uninsured or underinsured," wrote leaders of AARP, American Cancer Society Cancer Action Network, Consumers Union, Families USA, and Service Employees International Union. The joint letter was sent to House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid.