Hospitalist use increases: What is the benefit for EDs?

Hospitalists are becoming much more common in American health care and soon could change the way EDs work with physicians, says Ron Greeno, MD, chief medical officer and senior vice president of physician services at Cogent Healthcare in Laguna Hills, CA, one of several companies that provide hospitalist services across the country.

"I say that in five years, every hospital will have a hospitalist program in it," he predicts.

There are between 7,000 and 9,000 hospitalists practicing in the United States, Cogent reports. That number is expected to grow to about 25,000 by 2010, the company estimates.

One study found that hospitalists can significantly improve patient care.1 The researchers originally described the hospitalist model of inpatient care in 1996, and they later reported on the clinical, financial, educational, and policy implications of the trend. They found that implementation of hospitalist programs was associated with significant reductions in resource use, usually measured as hospital costs (average decrease, 13.4%) or average length of stay (average decrease, 16.6%).

But even if the potential benefits for patients and hospitals are huge, won’t your current physician base rebel at the idea of hospital-employed physicians taking over? Not necessarily. In fact, Greeno says doctors often are relieved that they can turn over some patient care.

"It’s usually not traumatic for physicians already treating patients in your hospital, but some medical staff are ready for this and some are not," he says. "You can’t just take patients away from medical staff, so the staff has to be ready to say, We’ll let hospitalists take unassigned patients from the ED,’ for instance. A lot of them gladly will turn over their patients to the hospitalist and stay in their offices."


1. Wachter RM, Goldman L. The hospitalist movement 5 years later. JAMA 2002; 287:487-494.