Just 25 years ago, the medical community didn’t have a word to describe physicians whose sole job was to care for patients in the hospital. That’s because, until the mid-1990s, the American hospital system only had a small number of such specialists. Today, 75 percent of U.S. hospitals have so-called hospitalists on staff, and the number of doctors in the field of hospital medicine has grown from a few hundred to more than 50,000. Hospitalists act as primary care doctors to one subset of the patient population, treating hospital inpatients for serious illnesses and scheduling necessary tests or procedures. For cancer hospital inpatients, hospitalists often help lead the care team, collaborating with other care team members and helping to coordinate treatment plan details and therapies designed to manage side effects.
What is a hospitalist?
“Hospitalists help advocate for patients and their families, working with other doctors and clinicians in coordinating the patient's care and determining whether the decisions made are working for the patient as intended.” - Kevin Tulipana, DO, FHM - Director of Hospital Medicine at our hospital in Tulsa
The term “hospitalist” was first coined by the New England Journal of Medicine in 1996, during a time when the number of patients admitted to U.S. hospitals was growing. At the same time, internal medicine and family medicine physicians were seeing more patients in their offices, limiting the time they had left to visit patients in the hospital. To compensate for these trends, health care leaders began hiring or redirecting existing staff physicians to focus their time on treating patients in the hospital.
Although most hospitalists are trained in internal medicine, some—like Dr. Tulipana—have a family medicine background. “I realized when I was practicing as a family medicine doctor in Springfield, Missouri, that it was hard for me to provide continuity of care and quality care to my patients in the hospital because of the number of patients I saw outside of the hospital,” he says. “This was at a time when hospital medicine was in its infancy. I took a leadership role in hospital medicine at a local hospital and realized I was able to really follow these patients and help them navigate the whole process, from diagnosis and treatment to their transition back to the outside world.”
Who do hospitalists work with?
In 2015, Dr. Tulipana joined Cancer Treatment Centers of America® (CTCA) as Director of Hospital Medicine because he wanted to use his hospitalist expertise to help patients with complex conditions. “Caring for cancer patients is more than just managing the illness,” he says. Hospitalists at cancer hospitals also coordinate with supportive care clinicians to help meet the patient’s diverse set of needs, from physical side effects and relationship challenges to nutritional deficiencies and faith-based concerns.
These doctors are also in a unique position to closely monitor patients and adjust medications as necessary. “We can watch trends in a patient’s sugar and blood pressure levels and take in a tremendous amount of data,” Dr. Tulipana says. “We’re truly able to see the whole picture with a different set of eyes under a much closer microscope.”