Post-Hospitalist Medicine is the discipline concerned with the medical care of post-acute patients. Physicians whose primary professional focus is post-hospital care are post-hospitalists. Typical community PCPs and most other NP/PA/extender models do not have the time or ability to effectively monitor patient care when the patient is in a post-acute facility. As a result, increased hospitalizations, readmissions and unnecessary ER utilization occur frequently, increasing overall health care costs. When patients become ill with an urgent or non-emergency problem, most traditional care models typically direct the patient to the ER, utilizing the ER as an outpatient clinic rather than going to the post-acute facility, examining and treating the patient on-site.
Contents
By comparison, other models providing limited results and exposure to facilities include the following:
Post-hospitalist medical services focus on providing better care to meet the needs of high-risk, medically complex patients with the following common diagnoses:
In many instances, this population of patient has multiple diagnoses, co-morbidities and their medical needs are extensive. In the past, these patients would have stayed in the hospital much longer and at much higher overall health care costs. Today, managing their care in less costly post-acute settings such as LTACs, Rehab Centers, Skilled Nursing and Long-Term Care Facilities is possible with the use of Post-Hospitalist Medical Services being provided on-site in these settings. Post Hospitalists provide these specialized medical services exclusively in these various types of post-acute facilities.
History
The term post-hospitalist was first attributed to Thomas Prose, MD, MPH, MBA, who coined the term in 2012. Prose founded General Medicine P.C.—a health care practice devoted to the practice of post-hospitalist medicine in 1983. The practice of post-hospitalist medicine is still new in the United States and—while it has not yet reached widespread adoption—is one of the faster growing of medical specialties.
Training
As a relatively new specialty, only recently has certification for specialty experience and training for hospital medicine been offered. The American Board of Hospital Medicine (ABHM), a Member Board of the American Board of Physician Specialties (ABPS), was founded in 2009. The ABHM was North America’s first board of certification devoted exclusively to hospital medicine. In September 2009, the American Board of Internal Medicine (ABIM) created a program that provides general internists practicing in hospital settings the opportunity to maintain Internal Medicine Certification with a Focused Practice in Hospital Medicine (FPHM).
Quality
Research shows that hospitalists reduce the length of stay, treatment costs and improve the overall efficiency of care for hospitalized patients. Post-hospitalists are leaders on several quality improvement initiatives in key areas including transitions of care, co-management of patients, reducing hospital acquired diseases and optimizing the care of patients.