Non–housestaff medicine services in academic centers: Models and challenges

Authors

  • Niraj L. Sehgal MD, MPH,

    Corresponding author
    1. Division of Hospital Medicine, University of California, San Francisco
    • Division of Hospital Medicine, University of California, San Francisco, 533 Parnassus Avenue, Box 0131, San Francisco, CA 94143
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    • Fax: (415) 514-2094

  • Hiren M. Shah MD, MBA,

    1. Division of Hospital Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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  • Vikas I. Parekh MD,

    1. Hospitalist Program, Division of General Medicine, University of Michigan Health System, Ann Arbor, Michigan
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  • Christopher L. Roy MD,

    1. Hospitalist Service, Division of General Medicine and Primary Care, Brigham & Women's Hospital, Boston, Massachusetts
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  • Mark V. Williams MD

    1. Division of Hospital Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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    • Mark V. Williams, MD, receives honoraria from the Society of Hospital Medicine for his role as editor-in-chief of the Journal of Hospital Medicine.


Abstract

Non–housestaff medicine services are growing rapidly in academic medical centers (AMCs), partly driven by efforts to comply with resident duty hour restrictions. Hospitalists have emerged as a solution to providing these services given their commitment to delivering efficient and high-quality care and the field's rapid growth. However, limited evidence is available on designing these services, including the similarities and differences of existing ones. We describe non–housestaff medicine services at 5 AMCs in order to share our experiences and outline important considerations in service development. We discuss common challenges in building and sustaining these models along with local institutional factors that affect decision making. Keys to success include ensuring an equitable system for scheduling and staffing, fostering opportunities for scholarly activities and academic promotion (defining the “academic hospitalist”), and providing compensation that supports recruitment and retention of hospitalists. With further work hour restrictions expected in the future and increased requests for surgical comanagement, the relationship between AMCs and hospitalists will continue to evolve. To succeed in developing hospitalist faculty who follow long careers in hospital medicine, academic leadership must carefully plan for and evaluate the methods of providing these clinical services while expanding on our academic mission. Journal of Hospital Medicine 2008;3:247–255. © 2008 Society of Hospital Medicine.

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