What Happens to Access and Services When Safety-Net Hospitals Are Sold?
How Health System Consolidation Affects Vital Community Services for Vulnerable Populations
Blog Post
It’s been more than 15 years since Wachter & Goldman named the burgeoning specialty of inpatient medicine “hospitalists,” and since then, hospitalists have effectively taken over care of hospitalized patients in the U.S. In a JAMA Health Forum study (and illustrated vividly in the chart above), my colleagues and I delve into the career trajectory and stability of these hospitalists.
We followed a cohort of 16,985 hospitalists in 2012 for seven years, and found that 1 in 4 shifted practice outside of the hospital at least temporarily (1 year or more). The chart shows movement of hospitalists to other settings over time, with some returning back to practice exclusively in the hospital.
Given the predominance of hospitalists in inpatient care, these findings have important implications for hospitals, who face the significant costs of hospitalist turnover, and for the quality of patient care. Most recently, the pandemic placed unprecedented demands on hospital-based clinicians, potentially creating even more career instability.
The study, Practice Trends and Characteristics of US Hospitalists from 2012 to 2018, was published in JAMA Health Forum on November 5, 2021. Authors include Kira L. Ryskina, Kaitlyn Shultz, Mark Aaron Unruh, and Hye-Young Jung.
How Health System Consolidation Affects Vital Community Services for Vulnerable Populations
Insights from Leaders of the Camden Coalition and NewCourtland Center for Transitions and Health
Information on Patients With Disabilities Is Not Systematically Collected in the U.S. Health System
LDI Fellows’ Study Uses State Examples of Raising Wages to Show Effects on Labor Force Participation
A Call for Urgent Action to Reduce the Gun Violence Epidemic
Five Strategic Recommendations from a Leading Health System