Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Both the Society of Hospital Medicine (SHM) and the American Academy of Family Physicians (AAFP) hold that the opportunity to participate as a hospitalist should be open to all interested physicians whose education, training, and current competence qualify them to serve effectively in this role.
During their training family physicians acquire the necessary attitudes, skills, and knowledge that enable them to provide continuing and comprehensive medical care across the spectrum of care settings, including the inpatient setting. Education in the primary management of hospitalized patients occurs during the required general inpatient ward and intensive care unit experiences. In addition, family physicians are required to train with general surgeons and surgical subspecialists, enhancing recognition and understanding of surgical disease states upon which hospitalists are frequently asked to consult or co-manage. Family medicine training also encompasses additional skills essential to the practice of hospital medicine, including participation in quality improvement, addressing the psychosocial needs of patients, coordinating across levels of care, and functioning as members of interdisciplinary teams. Given this training, many family physicians effectively manage their patients in an inpatient setting after the completion of their residency.
Demand for hospitalists continues to outweigh supply in the United States, including needs in underserved and rural areas. Hospitalists Trained in Family Medicine (HTFM) fulfill an important public health need by providing frontline inpatient services in a variety of geographic settings. In addition, while many HTFM focus exclusively on the care of adults, others are providing inpatient care across the spectrum of ages, as well as providing obstetric services. More than two-thirds of HTFM are also involved in the training of residents and medical students, enhancing the skills of our future physicians.
Recognition of achievement by HTFM from the SHM is available by meeting standards set for all hospitalists, regardless of residency training, in the form of the designation of Fellow of Hospital Medicine. HTFM also have the opportunity to professionally qualify and sit for the Recognition of Focused Practice in Hospital Medicine board examination. This examination is administered and recognized jointly by the American Board of Family Medicine and the American Board of Internal Medicine.
In consideration of the above factors, both the Society of Hospital Medicine and the American Academy of Family Physicians endorse and encourage the growing contribution of Hospitalists Trained in Family Medicine.
Note: This joint statement was developed by a joint task force of the American Academy of Family Physicians and the Society of Hospital Medicine.
Family physicians are participating on both sides of the new models of health care delivery, which utilize a dedicated inpatient physician (or hospitalist) to manage the inpatient care of general adult medicine patients referred by primary care physicians in the community. The AAFP believes that family physicians are well trained and highly qualified to serve in these roles, and that participation in such arrangements should be voluntary for both the referring physician and the patient involved.
Because continuity of care has been a hallmark of the specialty of family practice, the AAFP is especially concerned about safeguarding continuity in these new models through adequate communication. The following guidelines are intended to support quality care to patients and their families, and to clarify expectations for communication between physicians participating in such systems.
As health care systems experiment with models of inpatient care management (hospitalist systems), the AAFP supports and encourages the following principles:
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