Dr. Howell
As SHM CEO, I am constantly working to stay abreast of key factors that impact the hospital medicine specialty to ensure we, as your professional society, are equipped to help you navigate the field’s evolution. Using data from the SHM 2025 State of Hospital Medicine Report, preliminary data from the soon-to-be-released SHM 2026 Hospital Medicine Workforce Experience Report, and other internal and external data sources, here are five things I have been following:
- Artificial Intelligence (AI): Our 2026 Hospital Medicine Workforce Experience Report data shows that 64% of hospitalists are using AI, with 73% of those reporting benefits of usage. Surprisingly, only one-third of those using AI reported adequate training. We have also heard from our SHM Advisory Councils that decision support is the most common use, followed by chart summarization, coding, and ambient listening.
- Collective Bargaining: Our preliminary data show only 3.5% of attending physicians are in a union, while 22% report having informal discussions about unionization. These data are virtually identical to the rates reported two years ago in the 2024 Hospital Medicine Workforce Experience Report. I find this interesting for two reasons: First, it’s not uncommon to read about hospital medicine and unions in the lay press, and second, because unions have been in a growing percentage of residency programs. According to the Committee of Interns and Residents, one-quarter of house staff are in a union, which is a dramatic increase from the 10% reported in 2019 (16,000).
- Workload: Hospitalists typically manage the majority of a hospital’s census, and we’ve heard from members that, in many cases, there is increased pressure to have a higher census. Because variations in patient census are the norm, our data tries to explore various aspects that affect patient census and perceptions of the workload. Autonomy is one significant factor, and in the 2026 Hospital Medicine Workforce Experience Report, 50.2% of respondents noted having control over their clinical workflow, while 53% expressed that they have control over their non-clinical workload. The upcoming 2026 Hospital Medicine Workforce Experience Report has much more data to explore and unpack.
- Growth: Our research has shown that the number of hospitalists continues to grow, reaching 52,000 as calculated using 2023 data and the framework outlined in a 2022 Journal of Hospital Medicine article.1 This demonstrates that our specialty remains healthy, and the future continues to be bright for hospital medicine. Continued growth signifies even more opportunities for hospitalists to have a voice in healthcare and for SHM to partner with you as we grow together.
- Market Consolidation: Changes in ownership of healthcare systems and consolidation of hospital medicine groups continue to shift dynamics in the field, creating a mix of opportunities and challenges that affect the way institutions and individuals function.
In partnership with our members and SHM’s Board of Directors, we are exploring ways SHM can support the hospital medicine community as we collectively monitor the key factors outlined above and how they impact your clinical practice, professional fulfillment, and well-being.
As we are a membership society, our work is rooted in the feedback and involvement of our members. I invite you to share your success stories, your obstacles, and your suggestions on how we can ensure we are doing our best to serve you and provide you with the education and community you expect, while partnering with you to navigate your professional journey and deliver exceptional patient care.
Reference
- Lapps J, et al. Growth trends of the adult hospitalist workforce between 2012 and 2019. J Hosp Med. 2022;17(11):888-892. doi:10.1002/jhm.12954.