Dr. Robert Wachter: How the growth of hospitalists encapsulates innovation


Hospitalists represent a relatively new medical specialty, entering the healthcare arena approximately two decades ago. Their emergence, and subsequent growth, demonstrate significant healthcare innovation and show how innovation doesn't necessarily have to be tied to technology.

In a contributed piece in the Wall Street Journal, Robert Wachter, MD, professor and associate chairman of the department of medicine at University of California, San Francisco, writes the hospitalists' story is one that illustrates healthcare's capacity for innovation.

Traditionally, if a patient was admitted to a hospital, that patient's primary care physician remained in charge of their hospital care, a setup which Dr. Wachter says didn't work as well as planned. "Primary care physicians are extraordinarily busy in the office, so hospital patients often languished, or were cared for haphazardly by multiple specialists, with no one there to serve as the orchestra conductor," he writes. "And it became increasingly difficult for primary care physicians to keep up with new advances in both office practice and hospital medicine."

Then the role of the hospitalist emerged, a term which Dr. Wachter says he and a colleague coined in an article in the New England Journal of Medicine. Hospitalists are general physicians who care for and manage a patient's care while he or she is in the hospital. When the patient is discharged, the hospitalist returns him or her to the care of the primary care physician.

The hospitalist specialty is the fastest growing. Dr. Wachter cites the American Hospital Association which estimates there are approximately 50,000 hospitalists today in the U.S. And, their growth was spurred by a need that required a solution.Finding and filling this niche role is at the basis of disruption and innovation, Dr. Wachter writes.

"While the U.S. healthcare system isn't evolving as quickly as it needs to, the hospitalist story offers hope, demonstrating the capacity of the system to undergo transformative, even disruptive, change," he writes. "The keys are to articulate a vision as to why a change might lead to improved outcomes and efficiency; to conduct research that demonstrates that the theoretical advantages of the new model are, in fact, real; and then to thoughtfully, and humbly, navigate the complicated financial, political and regulatory waters."

More articles on innovation:

The pain points of innovation
Hospital innovation centers think outside the box to solve healthcare's biggest problems
15 hospital, health system chief innovation officers to know

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