Hospital Medicine Flourishing Around the World
Since last September, Anand Kartha, MD, MS, has headed the hospital medicine (HM) program at 600-bed Hamad General Hospital, the flagship facility for eight-hospital Hamad Medical Corporation in Doha, Qatar, a small nation of 1.8 million people located on the northeast corner of the Arabian Peninsula.
“Qatar has a world-class healthcare system,” he says. “But to me, it sometimes feels like 1999, with the beginnings of the hospitalist movement as a new model of care.”
Dr. Kartha, a native of India who trained at the University of Pittsburgh Medical Center Mercy and Boston University School of Medicine, was recruited by Hamad Medical Corporation to develop hospital medicine in response to the growing complexity of inpatient care—and of patients served.
“Hospital medicine, delivered 24/7 by attending physicians, is an important element of the Health Ministry’s strategy and vision,” he says. “They looked at Australian, British, and American health systems, trying to put together the best from each—adapted to local sensitivities.
“One reason I came here was to expand the hospitalist model and be part of its extraordinary growth and development.”
Dr. Kartha also participates in medical research and residency training. His group now employs 30 attending physicians, half of them recent hires from the U.S. and the U.K.
As in the U.S., international drivers for the hospitalist model of care include pressures to improve efficiency, throughput, and quality of care. Those drivers are especially in focus at Hamad General, which Dr. Kartha says has one of the busiest EDs in the world.
Hospital medicine programs are springing up in other parts of the world, too, often inspired by the success of the HM model in the U.S. Hospitalist pioneers from other countries pore over the published research and visit the U.S. to attend conferences like SHM’s annual meeting, with its programming for international members, or to complete fellowships or other trainings. U.S. hospitalists are invited to speak to groups in other countries. Some, like Dr. Kartha, are being tapped to build hospitalist programs around the globe.
“Models we are introducing include extended hours coverage, evenings and weekends, proactive discharge planning, and co-management with specialists. The health system is also rolling out an electronic health record.” —Anand Kartha, MD, MS
Hospital medicine can be introduced from the top down as a strategy by the public health system or from the bottom up by pioneers and advocates at the grassroots level.
Ron Greeno, MD, MHM, FCCP, has been active in hospital medicine since before the term “hospitalist” was coined. Currently chief strategy officer with IPC Healthcare, Inc., he was a founder in 1993 of Cogent Healthcare, which recently merged with Sound Physicians in Tacoma, Wash. Dr. Greeno says he is fascinated by the growth in international hospital medicine.
“I have been impressed at the number of countries that are represented at SHM [meetings] and the enthusiasm they show as they talk about their experiences,” he says. “What I see in these young, enthusiastic physicians from around the world is they are not naïve, but they are very idealistic. Their descriptions of their struggles remind me of our early days in Southern California.
“The international representatives at SHM all recognize the need for data. Every one of them feels their hospitalist model has advantages for their health system. But everybody’s struggling with the need for more resources. That’s the same in the U.S.”
Similarities and Differences
Many aspects of the experience in Qatar have been surprisingly familiar for Dr. Kartha.
“We are a Joint Commission-accredited hospital,” he says. “Our residency program is accredited by the American College of Graduate Medical Education. We are the flagship hospital for Weill Cornell Medical College in Qatar.”
