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The Hospitalist service at Johns Hopkins Hospital is pleased to announce the continuation of its highly rated Hospitalist elective. The goal of the elective is to expose residents who are considering a career in Hospital Medicine to our Hospitalist model, which differs substantially from most resident-training inpatient care models. It is also an excellent opportunity for residents, who are considering a general internal medicine fellowship or other sub-specialty fellowships, to experience training at Johns Hopkins Hospital. Throughout this elective, residents will work one-on-one with Hospitalist faculty, taking care of patients on a service that is organized to run without a resident team—a patient care model similar to what most practicing Hospitalists will experience following residency.
As hospitalized patients are increasingly being cared for by hospitalists rather than by outpatient primary physicians, the hospitalist movement continues to expand. The Society of Hospital Medicine (SHM) currently comprises more than 5,000 members, and trends in hiring and practice patterns suggest that the number of practicing Hospitalists will climb to approximately 30,000 over the next decade.
During residency, Internal Medicine trainees develop the ability to care for medical inpatients in a team environment. However, most Hospitalists practice without a resident team and are responsible for all elements of patient care. This difference between the typical teaching environment in residency and the actual practice of Hospital Medicine may leave some new Hospitalists unprepared for real-world practice. The goals of this elective are to:
- Expose residents who are considering careers as Hospitalists to a model of clinical care in which attending level care is provided directly to patients without a Housestaff team;
- Help residents develop skills in system-based practice that Hospitalists are expected to master, particularly those that revolve around patient throughput and efficiency of care. These include:
- appropriate triage of patients for the Hospitalist service
- judicious use of inpatient diagnostics and consultation
- determining the goals of hospitalization, and determining which medical issues can be safely deferred to the outpatient setting
- communicating the specific goals of hospitalization to patients, caregivers, and nursing staff, with early implementation of discharge planning
- leading an interdisciplinary approach through utilization of physical therapy, occupational therapy, nutritionists, speech therapy, palliative care, social work, and discharge planners
- optimal medical documentation and billing
- safely transitioning the patient back to the care of the primary care physician