The Family Way

The Hospitalist. 2007 November;2007(11):

November 1, 2007|The Hospitalist

Although the vast majority of physicians who practice hospital medicine in the United States are board certified in internal medicine, about 3% of hospitalists have their certification in family medicine.

How do differences in training, general outlook on the practice of medicine, or other factors affect their roles as hospitalists? Do practitioners of family medicine bring special skills to inpatient care? Why do they choose to become hospitalists instead of community-based family doctors? Does their certification in family practice give them a particular bond with the patient’s primary care doctor who may also be a family practitioner? How do they fit into the hospitalist picture, which is—at least in the U.S.—so dominated by internists?

To find out, we asked six hospitalists certified in family medicine:

Jasen W. Gundersen, MD, division chief of hospital medicine, University of Massachusetts Memorial Medical Center, and assistant professor, UMass. Medical School, Worcester, Mass.
Michael Kedansky, MD, lead hospitalist at the Kino Campus of University Physicians Healthcare Hospital in Tucson, Ariz., and clinical assistant professor of family and community medicine at the University of Arizona College of Medicine;
Elizabeth Chmelik, MD, director of the Inpatient Medical Program at Scott and White University Medical Campus at Texas A&M University in Austin;
Echo-Marie Enns, MD, a family practice hospitalist at the Peter Lougheed Center in Calgary, Alberta, Canada.
Felix Aguirre, MD, vice president of medical affairs at IPC-the Hospitalist Company, San Antonio, Texas; and
Jennifer Cameron, MD, a family medicine hospitalist with Central Texas Hospitalist who practices at St. David’s Hospital, Round Rock, Texas.

Drs. Gundersen, Kedansky, and Chmelik are members of SHM’s Family Practice Task Force.

SHM HIGHLIGHTS FAMILY MEDICINE

Family-medicine-trained physicians have an important role to play in SHM as well as the hospital medicine movement as a whole, says

SHM CEO Larry Wellikson, MD.

“Since our inception, SHM has been committed to being the home for all hospitalists, regardless of their board certification” he says.

SHM recently formed its Family Medicine Task Force, chaired by Dr. Gundersen, chief of the hospital medicine division at the University of Massachusetts Memorial Medical Center, Worcester. Gundersen’s taskforce has worked during the past year to raise the profile of family medicine-trained hospitalists and ensure that their voice is heard throughout the Society.

Building off momentum as the American Board of Internal Medicine moves closer to establishing Focused Recognition of Hospital Medicine as part of its maintenance of certification process, SHM leadership has been advocating similar considerations at the highest levels of the American Board of Family Medicine and the American Academy of Family Practice.

While Dr. Wellikson characterizes these discussions as “quite positive” but also as “first steps in a long road,” he is confident both organizations share SHM’s commitment to ensuring a growing role for family-medicine-trained physicians within hospital medicine.

“SHM looks forward to building on the work of our Family Practice Task Force and identifying new ways to support and expand this important group of hospitalists within our membership,” Dr. Wellikson says.

Anyone interested in getting involved in the work of SHM’s Family Practice Task Force is encouraged to contact Dr. Gundersen at gundersj@ummhc.org.

Training And Decisions

Most of the experts we spoke with agree training influenced their decision to become hospitalists. They cite the diversity of cases in family practice residency (adult, pediatric, and obstetric/gynecologic), which they felt they would also find in hospital medicine.

Dr. Gundersen, chair of SHM’s Family Practice Task Force, suspects internists and family physicians probably share one motivator for opting into hospital medicine: the hospital environment. “Even in residency, I liked my time in the hospital,” Dr. Gundersen says. Echoing that sentiment, Dr. Kedansky says he missed hospital work when he was in community practice.