Hospitalist: The new medical specialty

With fewer primary care physicians doing hospital rounds and inpatient care becoming more specialized, a new medical discipline has emerged: hospital medicine, which focuses on overall quality of care for hospitalized patients.

Its practitioners, called hospitalists, visit patients, coordinate consultations, follow up on tests and procedures, communicate with primary care doctors and specialists, meet with family members and generally monitor care.

More than 28,000 hospitalists are employed in the U.S., but few have made as big an impact as Dr. Alpesh Amin. He started the hospitalist program at UC Irvine Medical Center – one of the nation’s first – in 1998, focusing on clinical care, education, and improvement in quality of care and patient safety in the hospital environment.

“It’s a unique and wonderful program,” says executive director Amin. “It’s well known for its innovative approaches to quality-of-care improvement and patient safety, two areas in which UC Irvine Medical Center rates among the best in the country.”

These innovations include better coordination of care by doctors, nurses and others, as well as more efficient methods of processing physician orders and ensuring that patients are receiving proper doses of the correct medications.

Under Amin’s administration, the hospitalist program has expanded to include doctors in internal medicine, pediatrics, neurology, family medicine, geriatrics, infectious diseases and critical care medicine. And it has racked up some important distinctions:

• The UC Irvine Medical Center hospitalist program is ranked first among such programs at California’s university medical centers in ratings that analyze mortality and patient length-of-stay data.
• Nationwide, it ranks fourth out of 101 programs at university hospitals in similar ratings.
• The Advisory Board Company acknowledged it in 2007 as one of the premier hospitalist programs in the country and a model to replicate.

“I’ve always had a strong interest in developing a career that involves medical education and outstanding clinical care,” says Amin, who in 2008 received the American College of Physicians’ Laureate Award for excellence in medical care, education and research.

Amin, who has an M.B.A. in healthcare from UCI, is currently interim chair of the Department of Medicine – making him the first hospitalist in the country to head a medicine department at a university medical center.

“Alpesh does it all, from clinical research and teaching to leading our largest department and running a truly outstanding hospitalist service,” says Dr. Ralph Clayman, interim dean of the School of Medicine. “He is also one of the kindest and most compassionate individuals I know. We are very fortunate, as are our patients, to have him here at UCI.”