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By now we all know how the hospitalist career has risen in the American healthcare system in the past couple of decades, growing 50% between 2012 and 2019 alone.
A necessity of the times, hospitalists have become a mainstay in hospitals everywhere thanks to their mixture of management skills and healthcare administration. But there seems to be a lot of crossover between them and other primary care providers, such as emergency care physicians. After all, both happen to be doctors that work in the ER, so what’s the difference?
Turns out, a lot. The two are very different specialties, in both job description and their clinical duties. And yet, they each hold a crucial place in the hospital system, working off of each other to ensure improved levels of health care. So, let’s break it down:
- Emergency Doctors: The First Line Of Defense In The Hospital
- The Difference Between Hospitalists And Emergency Doctors
- How The Two Work In Tandem In The Hospital Environment
Emergency Medicine: The Frontline Of Healthcare
Emergency physicians are genuine rockstars when it comes to handling high stress situations in healthcare. I mean, that’s their entire business model but it’s no less commendable.
Emergency medicine is a specialty in which doctors are trained in advanced life support and management of possibly life threatening situations. They have to be quick on their feet regarding initial diagnosis, stabilizing the patient and overlooking their care while they are admitted into the ER under triage.
Some of the procedures they might be expected to perform include airway management, intubation and sedation in a rapid sequence.
All in all, emergency physicians go through the ringer to deliver swift, life-saving care. There was a time when it was one of the most coveted residency fields out there. But not anymore, considering we’ve been experiencing a steady decline of medical graduates attempting to get into the ER, with 18% of residency positions remaining unfulfilled in 2023. And no, we can’t attribute this to the physician shortage.
Emergency medicine is stressful, more so than any other field in the career. The high paced environment, coupled with high risk cases, means you are left exhausted, physically, emotionally and mentally. It’s why emergency physicians are more likely to suffer burnout and leave medicine altogether, despite having initial professional satisfaction.
And yet, emergency physicians are pivotal in the hospital, undergoing high stress situations whilst communicating with nurses, EMTS, technicians and even security. All of this is so that there are no lapses when it comes to caring for a high risk patient being admitted.
Hospitalists: Management And Care In One?
We’ve discussed what hospitalists are before but here’s a recap: Hospitalists are physicians tasked with caring for unassigned inpatients in the hospital until they get placed in the care of the specific medical or surgical team that they need.
Hospitalists are pretty much a transitory doctor, helping manage patients after they have been stabilized and are waiting to be processed further for specialized care.
You can find hospitalists in, well, hospitals only. They can be posted in the ER alongside emergency doctors, but also in intensive care, rehabilitation and post discharge institutes. Since they are only incharge during shifts in specific locations, their relationship with the patient ends as soon as they are moved to other departments.
While hospitalists are well versed in performing basic bedside procedures, often part of first response teams, and can provide medical consults if need be, they don’t have the same responsibilities as an emergency doctor.
Hospitalists don’t with high stress cases, only managing them after they have been stabilised. It’s why you’d find hospitalists mostly in short stay care units, managing patients and staff short term until another hospitalist takes their shift.
The Difference Between Hospitalist and Emergency Doctor
Emergency doctors are posted in the ER because they specialise in immediate care for life threatening situations. They are tasked with receiving patients brought into emergency alongside their team and performing life saving procedures such as resuscitation.
Meanwhile, hospitalists take care of what comes after. After the patient has been stabilized by the emergency doctor, a hospitalist takes over to look after their case until they have been assigned a specialist or discharged altogether.
Hospitalists aren’t going to be the main primary care provider, they just manage the patients placed under their care until the shift ends.
Emergency doctors are also specifically trained in emergency medicine, completing a residency that can span 4 years. Meanwhile, any physician or, even a nurse practitioner, can assume the role of a hospitalist. As a hospitalist, you need to have training in any primary care field such as family medicine, general medicine or internal medicine. It’s why so many hospitalists usually start out as internists in Internal Medicine.
They also have different pay grades. Because an emergency doctor is on call at all times with more high stress responsibilities, they get an average salary of $302,000 per annum. Meanwhile, the hours for hospitalists are more limited and there is no long term patient management, so they are paid the same as other doctors with similar duties. Which is around $200,000 per year.
A hospitalist cannot take on the role of an emergency doctor, who tends to be first on the scene when a patient is brought into the ER. Their presence ensures the patient’s history is updated while they are present afterwards, procedures are carried out within hospital regulations and maybe converse with the family after the situation has been stabilized and discuss the next step forward.
This way, an emergency doctor can focus on their immediate duties and not be distracted with the other work that needs taking care of in the ER and isn’t on time restrictions. That is why both hospitalists and emergency doctors often work together, with one taking the more passive clinical duties while the other does active patient care in emergency situations.
Emergency medicine is a whole different ball game when compared to hospitalists. That doesn’t mean that they aren’t pivotal in the healthcare infrastructure. But while both might be posted in the same department, they serve different roles.
