Saturday, August 12, 2006

Who Benefits?

Perhaps most people have now heard of hospitalists, a relatively new if inelegantly named medical specialty. As the name implies, hospitalists serve as doctors for hospitalized patients. If your medical condition requires that you be admitted to the hospital as an inpatient, you may be cared for by a hospitalist rather than by your regular physician.

The apparent advantages are obvious. The doctor is always near at hand and intimately familiar with hospital routines. No time is wasted traveling back and forth from office to hospital. Office practice is not interrupted by the needs of patients in the hospital.

It is a growing specialty. According to an article in the July 24, 2006 issue of Modern Healthcare, their numbers have grown from about 900 ten years ago to over 15,000 now and are expected to double in the next ten years.

I find the economics of this development interesting. So far as I can see, there is nothing in it that adds to the amount of medical work to be done. Nor am I aware of anything in it that reduces the amount of income available to support the physician services provided.

Yet for some reason the programs are not self-supporting. According to the Modern Healthcare article, some 97% of hospitals with hospitalist programs are subsidizing them to the tune of some $50,000 to $60,000 per year per hospitalist physician.

Hospitalists are well paid, but not inordinately so. The Modern Healthcare article reports their average annual salary during 2006 as $182,279.

All of which raises the question of who is benefiting financially from the hospital subsidies, which would seem to be a net addition to the amount of money going to support physician services.

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