The History of Pediatric Hospital Medicine in the United States, 1996-2019

The development of PHM was aided by support from three separate organizations, each with a different role: the Society of Hospital Medicine (SHM), the American Academy of Pediatrics (AAP), and the Academic Pediatric Association (APA). SHM was founded the year after the article by Drs Wachter and Goldman as the “National Association of Inpatient Physicians.” The name was changed to Society of Hospital Medicine in 2003 to reflect the evolving field of hospital medicine. While the organization is largely comprised of internists, a pediatrician has been on its board since 1998, and a pediatrics committee (now Special Interest Group, SIG) has been in existence since 1999. (Appendix Tables 1a and 1b; Appendix Figures 1a and 1b). In 2005, an SHM task force was formed to define PHM-specific Core Competencies that could serve as a basis for curriculum building and a definition of the field. These inaugural PHM Core Competencies were endorsed by all three societies; published in 2010 in SHM’s flagship journal, the Journal of Hospital Medicine¹⁰; and were recently revised to reflect changes to the field in the past decade.¹¹ SHM has provided valuable opportunities for hospitalists to develop knowledge and skills, particularly in matters related to healthcare operations and leadership, and it serves as a way to keep PHM connected with the larger hospital medicine community.

The AAP initiated its efforts to engage hospitalists in 1998 with the creation of a Provisional Section on Hospital Medicine (SOHM) that became a full section a year later. (Appendix Table 2; Appendix Figure 2) The SOHM listserv^®, created in 2000, became a major vehicle for communication among hospitalists—including individuals who are not members of the SOHM—with more than 4,000 subscribers currently. Of the SOHM achievements noted in the Table, one deserves special mention: In 2006, SOHM formally recognized the large number of hospitalists in community hospitals and established a subsection with Karen Kingry Olson, MD, as inaugural leader. Many of the hospitalists in these sites provide care not only to children on inpatient units but also in areas such as the nursery, delivery room, and emergency department, functioning “like water on pavement—filling all the cracks in the hospital,” as Eric Biondi, MD, MS, puts it.¹² It is a credit to the AAP and the PHM community that individuals from community hospitals have specifically been afforded leadership roles. SOHM membership has grown considerably from around 100 at inception to 2,700 in 2019. Participation in the AAP keeps PHM connected to the larger pediatrics community.

The APA established a Hospital and Inpatient Medicine SIG in 2001, the name of which was changed to Hospital Medicine SIG in 2004 (Appendix Table 3; Appendix Figure 3; Note: There had been an Inpatient General Pediatricians SIG in 1992, before the term hospitalist was coined, but it only met once.) In 2003, APA was the first national pediatrics organization to sponsor a PHM meeting. The meeting attracted 130 registrants and was considered successful enough to warrant another meeting in 2005, this time with SHM and AAP joining as cosponsors. In 2007, the triple-sponsored meetings became annual events, with 1,600 registrants at the 2019 meeting. The success of the initial meeting also caught the attention of APA leadership in another regard: a concern that the name of the organization might interfere with retaining hospitalists in the fold. In 2007, the Ambulatory Pediatric Association became the Academic Pediatric Association.¹³ Being connected with the APA affords PHM a connection to academic generalists and activities central to the APA, such as research and education.