SHM Definition of Hospitalists
Our society has an official definition of hospitalists: “Physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to hospital medicine.”
I wish the dictionary had used this definition because it gets to the heart of what hospitalists are and defines us in a positive way, on our own terms, and not in relation to other physicians. This definition embraces the broad range of professional activities that hospitalists perform. Our definition even allows for hospitalists to engage in nonhospital-based activities such as outpatient care. The key to this definition is the emphasis of our professional focus being the care of hospitalized patients.
The Big Tent
What the SHM definition of hospitalists recognizes is the great diversity of physicians who serve as hospitalists and the wide variety of roles we all play in the service of caring for hospitalized patients. Both MDs and DOs serve as hospitalists, and they do so as internists, family physicians, and pediatricians. That all these physicians can come together in the same professional organization speaks to the importance of the unifying goal of caring for hospitalized patients that defines what each of us does.
Further, hospitalists can be involved exclusively in patient care, research, teaching, or leadership or in a combination of these roles. Once again the common principle is the focus on the care of hospitalized patients. In fact our society and field are better, more robust, more innovative, and more responsive to the needs of patients because we represent such a broad range of physicians in so many roles.
Our coming together in one organization creates a “big tent” for hospital medicine and allows for cross-fertilization of ideas. However, like any big tent, the strength of our diversity also creates challenges. For example, from an educational standpoint, we need to design programs and materials that meet the needs of all hospitalists. We have found that we share much, regardless of the setting in which we practice, the age of our patients, or the type of work we do. Patient safety, leadership, palliative care, and quality improvement are just a sample of the issues that pertain to all hospitalists.
Additionally, understanding these issues and addressing them takes people who are experts in patient care, teaching, research, and leadership—precisely the job descriptions found within the SHM. I am proud that SHM is one of the only professional societies to include internists, family physicians, and pediatricians from community practice, academia, and industry. Our big tent even extends beyond physicians to include nurse practitioners, physician assistants, pharmacists, nurses, and others who enrich our society and strengthen our field. In fact, our name—the Society of Hospital Medicine—was deliberately chosen to reflect the big tent. We specifically rejected a name that focused on the word hospitalist—not because we are not proud of it, but because we wanted all of those who work to improve the care of hospitalized patients to feel welcome in our society and to join in our mission.
Hospitalist Takes Hold
The phenomenon we now see is the emergence of “surgical” and “OB” hospitalists who care for hospitalized patients who otherwise do not have access to such physicians. Whether these physicians will assume the role of improving the system to provide better care to all inpatients or serve solely as technicians who work a shift and go home remains to be seen.