Prior to ABIM's approval of the certification proposal, Dr. Wachter predicted that it would pass because hospital medicine meets the ABIM's NEDIM II criteria and the specialty can show that hospitalists improve efficiency and may also improve quality of care, although the quality advantage is supported at this point by suggestive rather than compelling evidence.
“The board thinks the world of what all of you do for a living. I've never heard anything at any ABIM meeting other than full support for the growth of the hospitalist field,” he told the packed hall at the SHM meeting.
The SHM has partnered with ABIM because roughly 90% of practicing hospitalists are internists. But a family physician in the audience who practices hospital medicine asked where all of this leaves him as well as the pediatrician-hospitalists. Dr. Gorman replied that the American boards of family medicine and pediatrics are watching the ABIM certification proposal closely and—if it's passed by the American Board of Medical Specialties—are likely to create similar pathways.
“Our biggest problem at SHM is everybody wants to partner with us,” said SHM chief executive officer Dr. Laurence Wellikson, who characterized hospital medicine as “the X-Games of medical specialties.”
Today hospitalists work in well over 2,600 hospitals. Currently, 40% of community hospitals have hospitalists, up from 29% in a 2003–2005 survey.
“Who cares that hospitalists are there 24/7?” he asked, ticking off the answer: “Primary care physicians, surgeons, orthopedists, emergency physicians, internists, patients, subspecialists.”
At the close of the update, Dr. Gorman asked the audience if they favored the certification process they had just been briefed on. In an impressive display, the hands of literally all of the roughly 1,000 attendees shot up. When she next inquired who was not interested in utilizing the certification process, not a single hand could be seen.
Under the proposed certification program, hospitalists probably will have a 3-year cycle for their recertification, according to Dr. Robert M. Wachter of the ABIM. Bruce Jancin/Elsevier Global Medical News