Starting a career in hospital medicine

Are you thinking of joining hospital medicine—the fastest growing medical specialty medicine today?

According to the 2010 State of Hospital Medicine Report Based on 2009 Data from the Society of Hospital Medicine (SHM) and the Medical Group Management Association (MGMA), the nationwide average for all cash compensation (not including benefits) was $215,000.

The background you need to become a hospitalist

Most physicians entering the hospitalist profession today are M.D.s or D.O.s with training in internal medicine. Others come from pediatrics, family medicine or an internal medicine subspecialty, such as infectious disease or pulmonology.

Physicians may choose to become certified in hospital medicine by the American Board of Hospital Medicine (ABHM), part of the American Board of Physician Specialties, or by the American Board of Internal Medicine (ABIM), which provides internists practicing in hospital settings the opportunity to maintain Internal Medicine Certification with a Focused Practice in Hospital Medicine.

Hospitalists are more than doctors without offices

The successful hospitalist understands the importance of aligning their clinical objectives for his or her patients with the organizational objectives of the hospital, must understand “systems thinking,” and needs to recognize the multiple systems of healthcare delivery in a hospital and how they relate to one another in the context of patient care.

To be successful practitioners, new hospitalists not only need to be up to date on clinical matters, but also must understand the business and administrative dimensions of the hospitalist specialty such as billing and coding, medical record documentation and risk management. Moreover, the nature of hospital medicine places a premium on interpersonal skills such as communication, conflict resolution and leadership.

Training. As part of the “onboarding” process with their new practice group and their facility, new hires should undergo a formalized orientation program that might include a variety of training vehicles such as self-study online tutorials, case studies, videos and presentations. A wide range of topics customized for hospitalists are available on topics such as best practices, managing referral relationships, and patient satisfaction. CME credits are often available for much of this training.

Mentoring. New hires typically participate in a mentoring program in which they are partnered with one or more experienced hospitalists in their practice group. Seasoned hospitalists mentor new hospitalists on a range of clinical and practical topics, such as optimizing patient care, working with interdisciplinary teams and the use of hospitalist-specific clinical communications technology. Mentors are also especially useful in helping the new hospitalist build relationships with hospital administration and the other members of the medical staff.

Performance monitoring. More and more hospitals are measuring hospitalists’ performance against a variety of internal and external benchmarks. The new hospitalist should familiarize himself with these measures early on so that expectations are clearly understood and mutually agreed to be acceptable.

Helping a new hospitalist learn and understand performance expectations is a responsibility of the entire practice group. Additionally, many groups have developed their own internally generated reporting capabilities that allow physicians to compare their performance on a number of important metrics. This information helps give positive feedback to hospitalists while identifying specific areas for improvement.

Questions to ask about hospitalist training programs

When looking at hospitalist job opportunities, here are some major questions to ask about training:

• What type of formal and informal training programs are in place at my new practice?
• Is there a true commitment to physician-hospital alignment at my new practice?
• Will my new practice partners help train me in a culture of teamwork, mentoring and commitment to quality?
• Will I receive training to help make me the very best hospitalist I can be?

To embrace your full potential as a hospitalist and prepare yourself for future leadership positions, it’s critical to augment your clinical skills with new expertise in promoting improved delivery of inpatient care, to the benefit of your patients, your facility, your practice and yourself.

Tim Lary is vice president of Physician Staffing for IPC The Hospitalist Company, Inc., a national physician group practice based in North Hollywood, Calif. Contact him at (800) 680-2492 or tlary@ipcm.com.