The state of hospital medicine in 2008

In the mid 1990s, a new model for hospital care began to take hold in the United States, in which a separate physician, who I dubbed a "hospitalist," assumed the responsibility for managing the inpatient stay in place of the primary care physician. A 2006 American Hospital Association survey indicated that there are more than 20,000 hospitalists in the United States, making this the fastest growing medical specialty in American medical history. In this article, I briefly trace the reasons for the field's remarkable growth, describe some of hospital medicine's key issues and concerns, and speculate about the future shape of the field.