Physician attitudes toward and prevalence of the hospitalist model of care: results of a national survey.
OBJECTIVE
We sought to determine the availability and utilization of, as well as physician attitudes toward, the hospitalist model in the United States.


METHODS
Using a telephone survey, we asked physicians who were board certified in internal medicine about their inpatient practice arrangements, the availability of hospitalist services, and their attitudes toward the hospitalist model. All physicians were generalists in active clinical practice. Using multivariable methods, we determined factors associated with attitudes toward the hospitalist model.


RESULTS
We were able to contact 787 of 2,829 physicians who were randomly selected from a national list of board-certified internists, of whom 400 agreed to participate. Most respondents were familiar with the term "hospitalist" and had hospitalist services available in their community, and 28% used hospitalists for their inpatients. Few (2%) reported the presence of the "mandatory" hospitalist model. Physicians reported that the model was more commonly available in Western states (84% vs. 55% to 63% in other regions, P<0.0001). Seventy-three percent thought hospitalist systems would reduce continuity of care. Only 28% thought that patients would prefer care from an inpatient specialist, but 51% thought patients might get better care, and 47% thought patients might get more cost-effective care in a hospitalist system. In multivariable models, physicians who were in solo practice, those in specialties with more inpatient practice, and those who had more patients hospitalized each month responded more negatively about the model, whereas those with hospitalists in their community were more positive.


CONCLUSIONS
Although agreeing that quality of care and efficiency might be improved, physicians were concerned about patient-doctor relationships and patient satisfaction in a hospitalist model. Future studies should determine the effect of the hospitalist model on these outcomes.
Auerbach
A D
AD
Department of Medicine, University of California San Francisco, San Francisco California, USA.
Nelson
E A
EA
Lindenauer
P K
PK
Pantilat
S Z
SZ
Katz
P P
PP
Wachter
R M
RM
D001291:Attitude of Health Personnel; D016009:Chi-Square Distribution; D003625:Data Collection; D020445:Hospitalists / Q000706:statistics & numerical data*; D006801:Humans; D007325:Institutional Practice / Q000706:statistics & numerical data / Q000639:trends; D007388:Internal Medicine / Q000706:statistics & numerical data; D016014:Linear Models; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology* / Q000706:statistics & numerical data; D015995:Prevalence; D011795:Surveys and Questionnaires; D014481:United States