Growth trends of the adult hospitalist workforce between 2012 and 2019

Abstract

Background Accurately identifying the number of practicing hospitalists across the United States continues to be a challenge. Characterizing the workforce is important in the context of healthcare reforms and public reporting. Objective We sought to estimate the number of adult hospitalists practicing in the United States over an 8‐year period, to examine patterns in growth, and begin to explore billing patterns. Design, Settings, and Participants Retrospective study using national Medicare Part B claims datasets. We applied a commonly used 90% threshold of billing hospital visit‐associated Healthcare Common Procedure Coding System codes to identify adult hospitalists in publicly available Medicare Provider Utilization and Payment data for 2012–2019. We then analyzed billing patterns for those identified hospitalists. Main Outcomes and Measures Identify trends in the number of identified adult hospitalists, including those self‐identified. Compare hospitalists' billing to that of non‐hospitalist Internal Medicine and Family Medicine physicians. Results We saw more than a 50% growth rate of practicing adult hospitalists between 2012 and 2019. In 2019, we identified 44,037 adult hospitalists. Conclusions The number of adult hospitalists continued to grow at a consistent rate, such that hospitalists are in the top five largest physician specialties in the United States. In the absence of more formal identification and consistent use by hospitalists, a threshold continues to be a meaningful tool to characterize the workforce.

Hospital medicine: It's gotten bigger, but can we make it better?

“…It is notable, however, that while Lapps et al 1 demonstrate a reciprocal fall in inpatient billing by this generalist workforce, the billing data do not offer insights into the actual structure of care delivery teams. These trends likely represent a significant decline in the participation of PCPs in the inpatient decision‐making for their patients, but these data provide no insight into those interactions.…”

“…In this issue of the Journal of Hospital Medicine , Lapps et al 1 report a continued rapid growth in licensed physicians practicing as hospitalists from 2012 to 2019. Hospitalists are now among the top five largest physician specialties and account for 30% of all inpatient Evaluation & Management (E&M) billing codes.…”

“…Strikingly, this rise has occurred despite a known national reduction in hospital beds per capita over this time. These trends raise several key questions: (1) What is driving this expansion? (2) Are inpatient care models changing with this hospitalist expansion?…”

Roles considered important for hospitalist and non-hospitalist generalist practice in Japan: A survey study

“…In the mid-1990s, an increased focus on quality and patient safety led to the evolution of the hospitalist specialty [1,2]. Since its inception, the number of hospitalists has continued to grow, with current estimates of at least 44,000 adult hospitalists in the United States of America (USA) [3]. An interesting aspect of the rapid expansion of hospital medicine is the growth of the eld beyond the USA including Asian Countries [4,5,6].…”

Finding your niche

“…When Bob Wachter and Lee Goldman introduced the concept of a “hospitalist” more than 25 years ago, few could have envisioned the evolution of the field 1 . Since the coining of the term in 1996, the number of hospitalists in the United States has grown to over 44,000, making it the fastest‐growing and one of the five largest medical specialties in the United States 2 . Wachter and Goldman recognized challenges that might arise for hospitalists interested in developing skills in other areas.…”