OBJECTIVE: Although hospitalists have been shown to improve both financial and educational outcomes, their ability to manage dual roles
as clinicians and educators has been infrequently demonstrated, particularly in the community setting where large numbers
of residents train. We evaluated the impact of hospitalists on financial and educational outcomes at a mid-sized community
teaching hospital 1 year after implementation.
DESIGN: Two hospitalist clinician educators (HCEs) were hired to provide inpatient medical care while participating in resident education.
Length of stay and cost per case data were calculated for all patients admitted to the hospitalist service during their first
year and compared with patients admitted to private physicians. The hospitalists’ top 11 discharge diagnoses were individually
assessed. For the same time period, categorical medicine residents (N=36) were given an anonymous written survey to assess the HCEs’ impact on resident education and service.
RESULTS: Resource consumption: length of stay was reduced by 20.8% and total cost per case was reduced by 18.4% comparing the HCEs
with community-based physicians. Reductions in both length of stay and cost per case were noted for 8 of the 11 most common
discharge diagnoses. Resident survey: over 75% of residents responded, with all noting improvement in the quality of attending
rounds, bedside teaching, and the overall inpatient experience. Residents’ roles as teachers and team leaders were largely
unchanged.
CONCLUSION: Hospitalist clinician educators as inpatient teaching attendings effectively reduce length of stay and resource utilization
while improving resident education at community-based teaching hospitals.
Key words hospitalist - clinician-educator - resident education - resource utilization