What a hospitalist does and why it matters

When you’re admitted to the hospital, the hospitalist becomes the ‘quarterback’ of your care team. Learn more about this important role.

You probably learned a lot of new health lingo during the heyday of the COVID-19 pandemic: shelter-in-place, PPE, N95 respirator, “flattening the curve,” zoonotic, etc. One term you probably heard often was “hospitalist.” But unless you were hospitalized, you may not have fully understood what a hospitalist does.

Let’s stay in our COVID-19 context to help fill in some gaps: When cases were on the rise and hospitals were overflowing with new patients, it was impossible for the hospitals’ infectious disease specialists to oversee the care of each and every patient admitted with the virus. Instead, hospitalists — physicians who work in the hospital setting and treat a wide array of illnesses and conditions — were charged with taking care of the bulk of those admitted. The hospitalists would admit patients, manage their care and coordinate with specialists — like infectious disease experts or pulmonologists — as needed.

A “hospitalist” history lesson

It’s a fairly new concept, in the scope of medical history. The term “hospitalist” was only coined in 1996. “Prior to the 1980s-90s, if you were admitted to the hospital for something like pneumonia, you were still treated in the hospital by your general internist or primary care physician,” said Dr. Jordan Anderson, a hospitalist at Vanderbilt University Medical Center. “Those physicians would ‘round’ on their admitted patients in the hospital in the morning, and then they’d see other patients in the clinic in the afternoon.”

Then, a shift started occurring in hospital systems. Administrators began to restructure their models, favoring the employment of hospital-based general internists. Once a patient was admitted, these physicians would take over their care. They would then release them back to their primary care doctors after discharge.

“It’s definitely become the standard model of care,” Anderson said. “There have been multiple research studies that have demonstrated that hospitals following the hospitalist model actually perform better in terms of quality outcomes and decreasing length of stay.”

The quarterback of hospital care

Anderson summed up the roles of a hospitalist as follows:

1. Admitting patients. When a patient lands in the emergency department, the ED staff first evaluates the patient. If the patient is deemed ill enough to be admitted for further evaluation, the hospitalist will see the patient, admit them and take over their care.
2. Managing care. The hospitalist is the one who’ll order diagnostic tests and work with the team to develop a therapeutic plan. That team may or may not include specialists, depending on how complicated the case is. If specialists are consulted, the hospitalist will serve as the “source of truth,” bringing information together from the various physicians involved to make decisions.
3. Discharging patients. The hospitalist will make a determination on when the patient is well enough to go home or to a post-acute care center and will serve as the liaison to the patient’s primary care team.

“Think of the hospitalist as the quarterback,” Anderson said. “We work with the necessary specialists and direct the patient’s care throughout the length of their stay.”