HOSPITALISTS: UCSF Launches Specialty Residency Program
A training program for doctors "who want to specialize in the care of hospital patients began last month at the University of California-San Francisco," American Medical News reports. Believed to be the first of its kind, the "hospitalist residency" program will be part of the internal medicine residency "track" at UCSF, and will be comprised "of a month-long elective in the second and third years" of residency. In addition, UCSF has established "a one-year postgraduate fellowship program in hospital care, designed to train physicians for a career as an academic hospitalist." AMNEWS reports that the hospital residency track "is the latest development in a burgeoning medical discipline devoted to the care of inpatients."
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Dr. Karen Hauer, a hospitalist at UCSF "who helped develop the new training track," said the program was started in response to "discussions with hospitalists around the country [that] revealed a variety of problems and issues not encompassed by traditional medical residencies." Many hospitals said there needed to be more specialized training in areas affecting hospitalists: end-of-life care, nonacute care, physician consulting, managed care, business, and patient and primary care physician communication. The specialists also said they would like "greater insight into 'big picture' issues" like health care systems and quality improvement. "As specialists in the care of medical inpatients, hospitalists should have a role in efforts to improve overall care in the hospital," Hauer said.
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AMNEWS reports that the hospitalist movement has arisen from "the migration of less acutely ill patients to ambulatory settings and the pressure on physicians to focus their efforts on outpatients." Critics, however, say hospitalists disrupt a patient's "continuity of care by intruding in the relationship with the primary care physician." Hospitalists "counter that continuity is already disrupted by a system that is fragmenting care," and that "greater communication between the inpatient physician and the primary care doctor" is what is needed. The UCSF program is being funded by a three-year, $712,000 Josiah Macy Jr. Foundation grant, AMNEWS reports (Moran, 8/17).