Hospitalist: Your In-Hospital General Medicine Expert

Medically Reviewed By William C. Lloyd III, MD, FACS

What is a hospitalist?

A hospitalist is usually a doctor, but can also be a physician assistant or nurse practitioner, who specializes in general medical care for hospitalized patients. Hospitalists practice solely in the hospital. They work shifts instead of making rounds—when your surgeon or regular doctor comes by to check on you when you are recovering in the hospital. This allows patients to see a hospitalist and receive in-hospital care whenever a need or question arises. Hospitalists promote safe, high-quality, patient-centered healthcare, while using hospital resources efficiently.

A hospitalist typically:

  • Evaluates a patient’s medical history and present illness

  • Performs physical exams and medical procedures

  • Orders and interprets imaging exams and laboratory tests

  • Prescribes medications

  • Diagnoses and treats patients who are hospitalized with acute illnesses

  • Collaborates with primary care doctors and other specialists to ensure continuity of care before and after hospitalization

  • Focuses on efficient use of hospital resources, patient safety, and quality and consistency of care to decrease hospital length of stay and readmission rates. This helps control healthcare expenses and has a positive financial effect.

A hospitalist may also be known as a hospital medicine doctor or hospitalist physician. A hospitalist is quite distinct from a house officer. A house officer usually refers to a medical intern or resident who is employed by the hospital during his or her medical training.

Who should see a hospitalist?

You may see a hospitalist if you are hospitalized with an acute illness. Hospitalists practice solely in hospitals and do not see patients in private practice outside a hospital setting. Most hospitalists are part of a hospital medicine group that rotates shifts to provide 24-hours-a-day, 7-days-a-week medical care for hospitalized patients. This differs from private practice doctors who have office hours and make rounds at the hospital.

Whether or not you see a hospitalist or your primary care doctor when you are hospitalized depends on a variety of factors. Most large healthcare systems and teaching hospitals have hospital medicine programs that employ hospitalists. In addition, many medical groups have arrangements with community hospitals and their hospitalists to provide care for their hospitalized patients. Furthermore, your health insurance or Medicare plan may have guidelines for using hospital medicine programs.

If possible, find out the policies of your primary care doctor, your healthcare coverage, and your hospital of choice before you are hospitalized. Depending on your particular situation, the hospitalist may have access to your outpatient electronic medical records. If not, your doctor’s office may share valuable clinical information, including previous diagnostic tests and laboratory results with the hospital to optimize decision-making and to avoid duplicating services.

When should you see a hospitalist?

You may see a hospitalist under the following situations

  • You are admitted to a general medicine unit for an acute medical illness or condition.

  • You are admitted for observation (usually less than 24 hours).

  • You are admitted to a specialty service, such as oncology or surgery, and your specialist requests a consult for a general medicine issue such as diabetes.

  • You were admitted to an intensive care unit (ICU) and have recovered enough to move to a step-down or general unit where you don’t need as much invasive monitoring and the nurse to patient ratio is a little lower (nurse takes care of more patients) than ICU.

What does a hospitalist treat?

A hospitalist treats hospitalized patients with acute medical conditions and illnesses including:

What does a hospitalist test?

A hospitalist can order or perform a wide variety of diagnostic and screening tests including:

  • Cardiac performance including electrocardiograms, cardiac echography, and stress testing

  • Endoscopy including gastrointestinal endoscopy and bronchoscopy of your airway

  • Imaging tests including X-rays, ultrasounds, CT (computed tomography) scans, and MRI (magnetic resonance imaging)

  • Laboratory tests including blood tests, urine tests, liver function tests, kidney function tests, heart enzyme tests, and blood and other tissue or fluid tests to find the cause of infections<

  • Monitoring vital signs including your breathing, heart rate, heart rhythm, blood pressure, blood oxygen levels, and brain activity

What treatments does a hospitalist do?

Hospitalists order or perform various procedures and treatments to manage acute medical illnesses and conditions. While many hospitalists have backgrounds in internal medicine and family medicine, their specific training and experience will determine what procedures and treatments they perform. Common procedures and treatments include:

  • Breathing treatments and medications including inhalers, nebulizers, incentive spirometry, coughing exercises, and chest physiotherapy

  • Chronic disease management including medication and counseling for diabetes, thyroid disease, and depression

  • Healthy lifestyle counseling including eating habits, exercise, and smoking<

  • Injury-related procedures including immobilizing sprains and broken bones

  • Minor surgical procedures including removal of foreign bodies, stitching minor cuts and wounds, and stitch or staple removal

  • Medication administration including intravenous fluids, antibiotics, heart medications, high blood pressure medications, pain medications, insulin and other diabetes treatments, diuretics, hormone therapy, and electrolytes

  • Mental health and behavioral treatment including counseling for substance abuse and anxiety

  • Nutrition therapy including enteral feedings through feeding tubes, nutrition supplement drinks and shakes, and counseling on ways to maintain normal weight and avoid malnutrition, particularly in elderly patients and patients with chronic diseases

  • Physical therapy including therapeutic exercise, balance training, mobility training, gait (walking) training, and preparation to leave the hospital upon discharge

Hospitalist training and certification

In most cases, a hospitalist will be an unfamiliar doctor to you. Your hospital may assign you a hospitalist if you are hospitalized with an acute illness, disease or injury. Your hospitalist will work closely with your primary care doctor or other specialist, but your primary doctor will not be in charge of your care in the hospital.

Hospital medicine is a relatively new area of medical practice. Board certification or recognition of Focused Practice in Hospital Medicine (FPHM) means the doctor completed a multiyear residency in a related specialty and additional training in hospital medicine. Keep in mind that a doctor or other provider may work as a hospitalist without formal FPHM training.

In general, a hospitalist is a licensed MD or DO who has:

  • Completed specialized residency training in internal medicine, family medicine, pediatrics, or other medical specialty

  • Passed a certification exam that validates the doctor’s proficiency in his or her medical specialty

  • Completed specialized, hands-on clinical training in hospital medicine

  • Passed a certification exam or an exam of recognition that shows the doctor has up-to-date knowledge and skills in hospital medicine

To maintain board certification or official FPHM recognition, a doctor must participate in an ongoing education and certification program.
If you or a family member is or will be hospitalized under the care of a hospitalist, you can learn about the doctor’s background information and hospital quality.

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  1. Definition of a Hospitalist and Hospital Medicine. Society of Hospital Medicine. http://www.hospitalmedicine.org/Web/About_SHM/Hospitalist_Definition/About_SHM/Industry/Hospital_Medicine_Hospital_Definition.aspx

  2. Hospital Medicine Eligibility. American Board of Physician Specialties. http://www.abpsus.org/hospital-medicine-eligibility

  3. Hospital Medicine Maintenance of Certification. American Board of Internal Medicine. http://www.abim.org/maintenance-of-certification/moc-requirements/focused-practice-hospital-medicine...

  4. Recognition of Focused Practice in Hospital Medicine. American Board of Family Medicine. https://www.theabfm.org/moc/rfphm.aspx

















Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Jan 24
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