Tuesday, May 24, 2005

If IM residents are not learning to be hospitalists already, what are the 3 years about anyway?

A recent article in the AMA News-soon to be a publication to which only AMA members are privy-describes what some perceive to be a need for a " hospitalist track" in the IM residency training program. It was not that long ago when the most pressing weakness of IM programs was thought to be too much emphasis on hospitalized patients and not enough on out patient care. Enter the requirement for continuity clinics. Basically as medicine residents we learned how to take care of sick people in hospitals.This including working with surgeons, neurologists , psychiatrists, ob-gyn,orthopedists and urologists.CCU,ICU and surg.ICU were places in which we became comfortable.
The Society of Hospital Medicine suggested several areas that need to be " beefed up":
working with nurses,pharmacists and administrators, (how one could work in the hospital as a internist and not work those folks is unclear), learn about hospital systems and infrastructure, (OK I didn't have that training and I'll admit I don't know what that means), end of life care and care outside the hospital, palliative care and of course "quality" improvement..
I think sometimes you just have to comment on the emperor's clothes.Here's the thing" Internists are already trained as hospitalists"

6 comments:

The Medicine Man said...
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The Medicine Man said...

Good points and as a hospitalist now teaching at an academic institution, I agree.

I've linked your post here.

Internal Medicine Doctor said...

Let's face it. It's another way for hospitals to take advantage of residents and contract cheap labor.

Enough is really enough.

I'm in an IM residency and most of what we do is hospital care. We work with everyone. sO now you just want us to keep doing it for another three years for a lot less money?

The Medicine Man said...

Mad House Madman,

No one is suggesting three more years of training in addition to a traditional IM residency!

A hospitalist track would simply be an option for people looking for an IM program who plan on becoming hospitalists. This is analogous to the many residency programs that have specific primary care tracks for people who don't plan on doing subspecialties.

John

Aggravated DocSurg said...

As a private practice general surgeon, I have found that the physicians trained as hospitalists tend to be the least efficient at providing care for inpatients. I know it seems backwards, but looking at the care our non-hospitalists internists deliver in comparison to hospitalists, ... well, there's no comparison.
I'm not convinced that the hospitalist movement is ready for prime time. The best systems in my opinion involve groups of primary care physicians who rotate their inpatient care responsibilities.

Internal Medicine Doctor said...

oh well, my bad!