AAFP - SHM Joint Statement on Hospitalists Trained in Family Medicine (Position Paper)

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. The Society of Hospital Medicine (SHM) and the American Academy of Family Physicians (AAFP) affirm that family physicians possess the education, training and competence required to serve in hospitalists roles. Both organizations support fair hiring practices in which decisions are made without bias toward specialty training. Family physicians should be given equal consideration for hospitalist positions.

Family physicians receive comprehensive training that equips them to provide high-quality inpatient care, as well as continuing care across the spectrum of clinical settings. Family medicine training within the hospital setting includes pre- and post-surgical management, critical care, emergency medicine, obstetrics and pediatrics. It also incorporates essential competencies for hospital medicine, such as quality improvement, patient safety, attention to patients’ psychosocial needs, coordination with subspecialists and ancillary teams, leadership of interdisciplinary care and procedural training.1-3 This comprehensive skill set equips family physicians for the full scope of hospitalist practice. Moreover, the breadth of family medicine training enables family physicians working as hospitalists to manage complex multimorbidity, behavioral health needs and social determinants of health while demonstrating strong diagnostic safety and resource stewardship. These capabilities reduce unnecessary utilization, support patient-centered decision-making and align with national priorities for high-value inpatient care.

Demand for hospitalists continues to exceed supply in the United States, especially in underserved and rural areas. Hospitalists trained in family medicine help meet an important public health need by providing frontline inpatient services across the spectrum of ages and in a variety of geographic settings. The number of family physicians working as hospitalists is increasing. In 2024, the American Board of Family Medicine reported that 10% of early-career family physicians and 4.3% of mid-or late career family physicians were working as hospitalists.4

Given the growing presence of family medicine-trained hospitalists, it is important to recognize the value these physicians bring to inpatient care. Hospitalists trained in family medicine achieve patient outcomes comparable to those of hospitalists trained in internal medicine, including similar readmission rates and length of stay.5 Beyond clinical outcomes, family medicine-trained hospitalists also contribute to graduate medical education. National survey data indicate that approximately 40% of family medicine residency programs use hospitalist services typically staffed by physicians trained in family medicine.6 Within these programs, hospitalists play a significant role in residency training, enhancing the skills of future physicians.

SHM recognizes hospitalists with the designation of Fellow of Hospital Medicine, and the general criteria for this recognition are identical for all physicians, regardless of residency training. Consistent with this principle, SHM and the AAFP call for equity in hiring practices for hospitalists certified in family medicine or internal medicine who have appropriate hospital medicine experience through residency training or independent practice.

Both organizations endorse and encourage the growing contribution of hospitalists trained in family medicine. (2014) (July 2026 BOD)

Note: This joint statement was developed by a joint task force of the American Academy of Family Physicians and the Society of Hospital Medicine.

References

  1. Nichani S, Brooks ME, Fitterman N, et al. The core competencies in hospital medicine-clinical conditions 2023 update. J Hosp Med. 2023; 18(Suppl 2):S6-S43.
  2. Nichani S, Brooks ME, Bryson C, et al. The core competencies in hospital medicine: procedures 2025 update [published online May 14, 2025.]. J Hosp Med. Accessed February 11, 2026. https://shmpublications.onlinelibrary.wiley.com/doi/full/10.1002/jhm.70042
  3. Nichani S, Fitterman N, Lukela M, et al.; Society of Hospital Medicine. The core competencies in hospital medicine 2017 revision. Section 3: healthcare systems. J Hosp Med. 2017;12(4 Suppl 1):S55-S82.
  4. Davis CS, Ha E, Morgan Z, et al. The Family Medicine Factbook. American Board of Family Medicine, ABFM Foundation, Center for Professionalism & Value in Health Care; 2024.
  5. Mustafa Ali M, Mustafa S, Sabah M, et al. Comparison of hospitalization and post-hospitalization outcomes among family medicine hospitalists and internal medicine hospitalists in a tertiary center: a prospective cohort study. JAP Academy Journal. 2023;1(1):1-10.
  6. Baldor R, Savageau JA, Shokar N, et al. Hospitalist involvement in family medicine residency training: a CERA study. Fam Med. 2014;46(2):88-93.