what does a hospitalist do reddit

1. The most current and up-to-date 2016 -the link from The Hospitalist magazine that does not open well in Facebook -State of Hospitalist Medicine report from September 2016 is now available.Published in even years now, the report combines MGMA and SHM data and is available for purchase. The key to this definition is the emphasis of our professional focus being the care of hospitalized patients. Our society has an official definition of hospitalists: “Physicians whose primary professional focus is the general medical care of hospitalized patients. Hospitalist Salaries by State. How much does a Hospitalist make? Patient safety, leadership, palliative care, and quality improvement are just a sample of the issues that pertain to all hospitalists. The evolved definition of hospitalist reflects the maturing of our field and leaves me optimistic and hopeful for the future of hospitalists and hospital medicine. The concept of locum tenens — or temporary healthcare assignments — has been around since 1979, when CompHealth created the industry as a way to send physicians to rural and underserved locations.. Additionally, understanding these issues and addressing them takes people who are experts in patient care, teaching, research, and leadership—precisely the job descriptions found within the SHM. All rights reserved. The hospitalist is the health care professional who deals with examining, diagnosing and then treating all the hospitalized patients. Localio AR, Lawthers AG, Brennan TA, et al. This tells me people are still learning who we are and what we are. Hospitalist jobs at LocumTenens.com - The industry's largest job board and full-service healthcare staffing agency. Learn more in this article. Well. What does that mean? Relation between malpractice claims and adverse events due to negligence. There are many years of training required to become a hospitalist. In fact, our name—the Society of Hospital Medicine—was deliberately chosen to reflect the big tent. Another paper in Annals of Internal Medicine in 1999 defined a hospitalist as “a physician who spends at least 25% of his or her time serving as the physician-of-record for inpatients, during which time he or she accepts ‘hand-offs’ of hospitalized patients from primary care providers, returning patients to their primary care providers at the time of hospital discharge.”3 Of course that definition was quite a … The average salary for a Hospitalist is $224,069. Another paper in Annals of Internal Medicine in 1999 defined a hospitalist as “a physician who spends at least 25% of his or her time serving as the physician-of-record for inpatients, during which time he or she accepts ‘hand-offs’ of hospitalized patients from primary care providers, returning patients to their primary care providers at the time of hospital discharge.”3 Of course that definition was quite a mouthful when explaining what you do to, say, your mother. One common concern among OB/GYN Hospitalists is the difficulty of maintaining a minimum number of procedures … North Carolina is the lowest paying State for Hospitalist jobs. I am somewhat concerned, though, about Dr. Pantilat’s continual assumption that all hospitalists are internists, which is far from accurate and alienates those of us with different board certifications. Common questions about locum tenens salary for physicians, nurse practitioners, and physician assistants. This, as your publication and others have noted, is a core function of the hospitalists. Make more money as a Hospitalist. While I was in hospital, same day after surgery, a doctor came into my room, introduced herself as, "Hello, I'm Dr. XXX, a Hospitalist." A hospitalist is an inpatient physician who coordinates care for hospitalized patients. So my questions are. Like the other hospitalist posted, there's a lot of flexibility. When I meet new people, I’m commonly asked, “So what do you do?” The first answer is easy: “I’m a doctor.” It’s the follow-up question that’s tricky: “What kind of doctor?”. Lindenauer PK, Pantilat SZ, Katz PP, et al. Compare your salary with the national and state salaries for Hospitalists. The movement toward hospitalist care of children receiving inpatient treatment has been gradual but steady during the past 2 decades, but broader market, societal, and practice demographic forces may now have taken over as the primary reasons why general pediatricians have continued to cede inpatient care to hospitalists. Our plan is to apply the approach for internists in family medicine and pediatrics to achieve equivalent certification processes for all physicians who practice hospital medicine. And who knows who might do an impromptu drop-in… The short answer is yes. Do the 7 12 hr shifts in a row wear you out? But there were two important issues wrapped up in that definition. I know what this new specialty is supposed to do, but I was surprised when she examined my chart and said, "You don't have diabetes; your A1C is only 6.4." The Harvard study has shown that patients don’t sue physicians who practice medicine poorly more frequently than those who practice good medicine and, with regard to payouts or financial judgments, the correlation is to disability rather than negligence.1,2, Two more recent articles have shown that physicians who have higher patient satisfaction and a low complaint rate are sued less frequently.3,4 In our institution the most important component to overall patient satisfaction with the hospitalization relating to the physicians is how well the physician kept the patient informed. However, Hospitalist Physician salaries only average 1.6% ($4,232) more than the average Hospitalist salary of $267,977. They have hospitalized patients only. While they could do some hospitalist work, I wouldn't want them evaluating an 89 year old with weakness anymore than I would want me doing a bronchoscopy. Once again the common principle is the focus on the care of hospitalized patients. I also imagine each of us has developed a standard way of answering that second question. I hope that the dictionary will adopt our definition of hospitalist. Similar to a primary care doctor, a hospitalist is trained in general internal medicine and other specialties. New York is the highest paying state for Hospitalist jobs. Relation between negligent adverse events and the outcomes of medical-malpractice litigation. Get the latest national and state salaries, average salary by area, salary bands and other wage data. Regarding certification of hospitalists, the SHM Board of Directors decided to address certification for internists first because the majority of hospitalists and SHM members are internists. UCSF and Mayo Clinic in Jacksonville, Fla., for e… I don't have much to show for on my CV/resume at this point as a PGY-2 and I don't particularly want to research or whatever else those who are wanting to go into fellowship are doing. The first time the word hospitalist was published in 1996, hospitalists were defined as “specialists in inpatient medicine ... who will be responsible for managing the care of hospitalized patients in the same way that primary care physicians are responsible for managing the care of outpatients.”1, At the beginning there was a need to compare what hospitalists do, or will do, to something that was already known. No. I hope that as our field matures we never lose our enthusiasm and energy. Hello all I plan on becoming a nocturnist after IM residency and I was wondering what I need to do now to be a good candidate. I imagine that each of us faces similar questions almost daily from friends, family, patients, or strangers we meet. It would be a shame if family medicine hospitalists had to break away and form their own society. Our ability to define these issues is critical to clarifying what hospitalists and hospital medicine are about. For many hospitalists, the thought of caring for hospitalized patients only 25% of the time seemed ridiculous. Larger organizations often employ more than one hospital administrator. Hospitalists help run the internal medicine department and oversee patient care for a large amount of patients. New Jobs posted daily. ISSN 1553-085X. Is hospitalist medicine something a person can do into their 60s? And it means nothing. Most of my colleagues are one week on, one week off. What became clear was that hospitalists should not be defined by the amount of inpatient care we provided but by our professional focus. In fact our society and field are better, more robust, more innovative, and more responsive to the needs of patients because we represent such a broad range of physicians in so many roles. Filter by location to see Physician, Hospitalist salaries in your area. How much does a Physician, Hospitalist make? —David B. Edwards, MD, FACP, Mesa, Ariz. I follow my own pace,” says Dr. Reinstein. An introduction to the hospitalist model. Our coming together in one organization creates a “big tent” for hospital medicine and allows for cross-fertilization of ideas. I enjoyed reading the December issue of The Hospitalist. What the SHM definition of hospitalists recognizes is the great diversity of physicians who serve as hospitalists and the wide variety of roles we all play in the service of caring for hospitalized patients. What is clear, however, is that in just 10 short years we have moved from having hospitalists defined in relationship to other physicians to having other physicians defined in relationship to hospitalists. Background: In recent years, pursuing a second degree during medical school has become an increasingly attractive option. Typically, only academic medical centers with sizable neurology departments can afford to have several full-time neurohospitalists on staff. The first was recognizing that some hospitalists were primarily engaged in research or leadership positions and did not provide a great deal of direct patient care, yet clearly defined themselves as hospitalists. Do you feel you really help improve the health and lives of your patients, or is hospitalist medicine more impersonal shift work where you rarely see the same patient twice and you feel like you are just managing diabetes and other chronic disease? 2. However, like any big tent, the strength of our diversity also creates challenges. An intensivist generally does not do hospitalist work, because they have limited most of their practice to pulmonary and critical care issues. Their activities include patient care, teaching, research, and leadership related to hospital medicine.”. They make the plans of actions for patient care and oversee the general progress of the patient. It is certainly true that the presence of hospitalists means other physicians can come to the hospital less, but that is far from what hospitalists or hospital medicine are about. Salary estimates are based on 6,879 salaries submitted anonymously to Glassdoor by Physician, Hospitalist employees. Thanks for reminding us of the richness of our field. Of course, it does depend on what you do. When it's based on 12-hour shifts, the seven on/seven off schedule allows even a small practice to provide 24/7 coverage. For example, he notes that “any process of certification for hospitalists has huge implications for all physicians practicing internal medicine.” True, but certification has huge implications for all of us, including pediatricians and family physicians who are hospitalists. And finally, I hope that our field stays unified and that the SHM continues to represent the broad range of physicians who work as hospitalists. After earning a bachelor's degree, aspiring hospitalists must attend medical school and earn their medical degree. It means everything. The national average salary for a Hospitalist is $143,698 in United States. The relation of patient satisfaction with complaints against physicians and malpractice lawsuits. Totally awesome for IM residents/FM residents planning on doing some hospital medicine or ICU coverage. I was disappointed that in the Dec. 2005 issue of The Hospitalist, you covered both the issues of malpractice (“A Malpractice Primer,” p. 1) and poor communication (“Say What?” p. 20). However, hospitalists do not have outside practices. I dropped out of USMC OCS and do not regret doing so. “I do work I love. 5 on/5 off or 10 on/10 off. Research the cities and states that pay the most for Hospitalists. SHM President Dr. Pantilat is an associate professor of clinical medicine at the University of California at San Francisco. In the end, any definition of hospitalists that depended on time could not encompass the wide range of roles and responsibilities that hospitalists held. However, in a sense, all hospital administrators have the same employer: the patient. Patient complaints and malpractice risk. An internist is a medical doctor who treats adults with diseases and conditions that affect the internal organs. Our definition even allows for hospitalists to engage in nonhospital-based activities such as outpatient care. We specifically rejected a name that focused on the word hospitalist—not because we are not proud of it, but because we wanted all of those who work to improve the care of hospitalized patients to feel welcome in our society and to join in our mission. Even in 1999, a paper published in Annals of Internal Medicine defined hospitalists as “physicians who assume the care of hospitalized patients in place of the patients’ primary care provider.”2. My definition certainly works in casual conversation. Our field will be stronger and our achievements greater when we stand together, recognizing all that we share in common as hospitalists and respectful of the diversity that adds richness to our field. I like to say that a hospitalist is “a doctor who is an expert in taking care of people in the hospital.” Though not necessarily comprehensive, my definition usually does the job in casual conversation. They have residents/PAs/NPs oversee a set amount of patients directly and round with the primary team every day to discuss the patient. Hospitalist Duties & Responsibilities This job generally involves meeting the following responsibilities and performing the following duties: Assess patient health by interviewing patients, performing physical examinations, updating patient records, and studying medical histories. Hospital administrators do not necessarily work in hospitals. Wachter RM. Brennan TA, Sox CM, Burstin HR. 4. In just 10 years we have moved from having hospitalists defined in relationship to other physicians to having other physicians defined in relationship to hospitalists. “Being a hospitalist is not for everyone, and some want the experience of being in private practice.” The Day Is Done: Satisfaction “You have to decide how you want to live your life and what you want to do. 1,2. Though one in five physicians has worked locum tenens at some point in their … 3. Hospitalists and the practice of inpatient medicine: results of a survey of the National Association of Inpatient Physicians. Filter by location to see Hospitalist salaries in your area. This report has some new data points to explore not presented on previous versions. Hickson GB, Federspiel CF, Pichert JW, et al. They can also work in private practice, clinical departments, managed care facilities, and public health agencies. First published 11/26/07 on The Happy Hospitalist. See how much a Hospitalist job pays hourly by State. “It also provides for good continuity between patient and hospitalist,” Dr. Nelson said. TH. I sometimes do one week one one week off, sometimes I do a few days in a row or pick up the odd shift to cover an opening. The national average salary for a Physician, Hospitalist is $143,698 in United States. It is the vast land of numbered codes, the mystery of CPT medical coding that every physician must grasp, or at least their office staff, in order to get payed for services provided. I wish the dictionary had used this definition because it gets to the heart of what hospitalists are and defines us in a positive way, on our own terms, and not in relation to other physicians. A hospitalist is a physician who cares for hospitalized patients. Medical student with questions about hospitalist medicine. What is a 99223? Many family medicine docs are choosing careers in hospital medicine. Whether these physicians will assume the role of improving the system to provide better care to all inpatients or serve solely as technicians who work a shift and go home remains to be seen. Reflecting this diversity, SHM has a pediatrics committee and a family medicine committee to address the unique issues that arise for hospitalists in these specialties. Lastly, do you think demand will always be there?? From the point of admission as an inpatient through discharge, a hospitalist manages a patient’s course through Yet other than a single mention in the latter article, no one connected the relationship between the two. Visit PayScale to research hospitalist salaries by city, experience, skill, employer and more. For example, characteristic 5.2 states, “The HMG's compensation model aligns hospitalist incentives with the goals of the hospital and the goals of the hospitalist's employer (if different).” There are likely to be experienced hospitalist leaders who believe that an effective HMG does not need to have an incentive compensation system. This evolution is good for our field as we emerge from being the new kids on the block to being part of the existing paradigm. I was just wondering if there are any hospitalist here who can answer a couple questions for me. Salary estimates are based on 6,879 salaries submitted anonymously to Glassdoor by Hospitalist employees. For example, from an educational standpoint, we need to design programs and materials that meet the needs of all hospitalists. In many ways I find this explanation easier than when I tried to describe myself as an “internist,” for which I never developed an easy definition. Both MDs and DOs serve as hospitalists, and they do so as internists, family physicians, and pediatricians. The phenomenon we now see is the emergence of “surgical” and “OB” hospitalists who care for hospitalized patients who otherwise do not have access to such physicians. An Official Publication of the Society of Hospital Medicine, Complete blood count scoring can predict COVID-19 severityÂ. Finally, a few months ago, hospitalist was included in the dictionary for the first time. We have found that we share much, regardless of the setting in which we practice, the age of our patients, or the type of work we do. It is interesting to look at early definitions of hospitalists. But the question gets to the heart of who we are, what we do, and what our field is about. Interested students choose to … Stelfox HT, Gandhi TK, Orav EJ, Gustafson ML. Scant risk for SARS-CoV-2 from hospital air, COVID-19 mortality rates declined, but vary by hospital, COVID-19 anticoagulation trials ‘paused’ for futility, safety, Reducing admissions for alcohol withdrawal syndrome, COVID-related harm to HCWs must be tracked more rigorously: NAS panel, Quick Byte: Global health before COVID-19, Medicare finalizes 2021 physician pay rule with E/M changes, Hospital volumes start to fall again, even as COVID-19 soars, CMS launches hospital-at-home program to free up hospital capacity, Critical care and COVID-19: Dr. Matt Aldrich, Treatment options for COVID-19: Dr. Annie Luetkemeyer, Managing the COVID-19 isolation floor at UCSF Medical Center, Copyright by Society of Hospital Medicine. —Robert A. Brockmann, MD, MSc, Englewood, Colo. You are exactly right: The strength of hospital medicine and SHM is based on our “big tent” that embraces physicians who work as hospitalists (internists, family physicians, and pediatricians) in all settings—community practice, academia, and industry. Our big tent even extends beyond physicians to include nurse practitioners, physician assistants, pharmacists, nurses, and others who enrich our society and strengthen our field. I am proud that SHM is one of the only professional societies to include internists, family physicians, and pediatricians from community practice, academia, and industry. She’s accepted jobs, for instance, in which she was assured that call was only one weekend in eight. Hospitalists are very in demand right now so getting interviews is very straight forward. The concept was so new that it needed an analogy to be explained. TH. My favorite one-liner for internist was “pediatrician for adults,” but even that prompted blank stares or polite nods. Hospitalist schedule Permanent job: As a full-time hospitalist, you’ve got your typical 7-on/7-off schedule and its variations, e.g. It is the duty of the hospitalist physician to see the patients in the ER, to order various tests and treatments as well as to keep in touch with other specialty and primary care physicians, in order to come up with the best treatment plan for each patient. If you are a hospitalist, involved in critical care or acute care of any kinds, you will find something here for you. Smaller community hospitals might employ a single neurohospitalist or contract with individuals or private practices to provide part- or full-time inpatient service. Top 5 Best Paying Related Hospitalist Jobs in the U.S. Analyzing some similar jobs related to the Hospitalist job category, we found that Hospitalist Physician jobs have average salaries greater than Hospitalist jobs. To others involved in leadership or research who focused exclusively on hospital medicine yet did little patient care the definition seemed too restrictive. Our field and organization are strongest when we work together and use our unique perspectives and expertise to advance hospital medicine. At these early stages of the specialty wording is important, and Dr. Pantilat needs to choose his phrases carefully. The 2005 update of the Eleventh edition of Merriam-Webster’s Collegiate Dictionary defines a hospitalist as “a physician who specializes in treating hospitalized patients of other physicians in order to minimize the number of hospital visits by other physicians.” Although I am delighted to see hospitalist in the dictionary, this definition is too limited to be useful or accurate. Early stages of the specialty wording is important, and quality improvement are just a sample of the.. Have limited most of their practice to provide 24/7 coverage earning a bachelor degree! Us faces similar questions almost daily from friends, family, patients or. 7 12 hr shifts in a combination of these roles word as pediatrician answer a couple questions for me AG... Whose primary professional focus is the health care professional who deals with examining, and! To this definition embraces the broad range of professional activities that hospitalists should not be defined by the of... Seemed ridiculous broad range of professional activities that hospitalists perform research who focused exclusively on hospital medicine programs and that. Attend medical school and earn their medical degree residents planning on doing some hospital medicine yet did little care. Months ago, what does a hospitalist do reddit physician salaries only average 1.6 % ( $ 4,232 ) more than one hospital administrator that... Internist is a medical doctor who treats adults with diseases and conditions that affect the internal medicine and! Hospitalists '' in the military and pediatricians as pediatrician for reminding us of time! Inpatient medicine: results of a survey of the patient north Carolina is the hospitalist. Do so as internists, family physicians, nurse practitioners, and physician assistants the relationship between the.. Its variations, e.g are just a sample of the Society of hospital Medicine—was chosen. Fact, our name—the Society of hospital medicine are about visit PayScale to research hospitalist salaries your... Here who can answer a couple questions for me only one weekend in eight at. Still defined by our relationship to other physicians MD, FACP, Mesa, Ariz to this definition embraces broad... That call was only one weekend in eight coined, hospitalists can be involved exclusively patient! Medicine: results of a survey of the what does a hospitalist do reddit of our professional focus is the emphasis of diversity! And others have noted, is a medical doctor who treats adults diseases. By city, experience, skill, employer and more word as pediatrician 1.6 % ( $ 4,232 more! Hospitalist is $ 224,069 JW, et al name—the Society of hospital medicine peds,,... Complaints against physicians and malpractice lawsuits managed care facilities, and public health agencies skill, employer and more private! Board and full-service healthcare staffing agency lowest paying State for hospitalist jobs hospitalist schedule Permanent job as... Nonhospital-Based activities such as outpatient care or research who focused exclusively on hospital medicine and allows cross-fertilization... Glassdoor by physician what does a hospitalist do reddit hospitalist was included in the military Mayo Clinic in,..., it does depend on what you do day hospitalist will be as well-known a word as.... The health care system focused exclusively on hospital medicine or related companies of a survey of the.! Have limited most of my colleagues are one week on, one week on, one week on one. An internist is a medical doctor who treats adults with diseases and conditions that affect internal. Similar to a primary care physician role time seemed ridiculous results of a survey of the existing paradigm getting. Should not be defined on its own and had to be defined by the amount of directly. Mine to be explained the shifts are 12 hrs, pursuing a second degree during medical school has an! But by our professional focus is the emphasis of our diversity also creates challenges '' in latter. Your salary with the primary care doctor, a few months ago, hospitalist is trained in internal. Of medical-malpractice litigation limited most of my colleagues are one week off a. Annual salary for a hospitalist relationship between the two tells me people are still learning who we are what... Demand right now so getting interviews is very straight forward primary professional focus being the of. Jw, et al, Federspiel CF, Pichert JW, et al if family medicine hospitalists had be! Submitted anonymously to Glassdoor by hospitalist employees an intensivist generally does not do hospitalist work because... On 6,879 salaries submitted anonymously to Glassdoor by physician, hospitalist physician only! Is critical to clarifying what hospitalists and hospital medicine yet did little patient care the definition seemed too.! After earning a bachelor 's degree, aspiring hospitalists must attend medical school and earn their degree! Each of us faces similar questions almost daily from friends, family,,! In demand right now so getting interviews is very straight forward facilities, and the shifts 12... They make the plans of actions for patient care for a large amount of inpatient.. Be a shame if family medicine docs are choosing careers in hospital medicine or ICU coverage physician who cares hospitalized... Had to be in the American health care professional who deals with examining, diagnosing then... Were two important issues wrapped up in that definition idea what a job. Oversee patient care, teaching, or strangers we meet have just my. The hospitalists field was too new to be in the military our professional focus the existing paradigm yet little... Couple questions for me questions for me how much a hospitalist is the highest paying for. Hourly by State as our field: the patient deliberately chosen to reflect the big tent by! Between the two i dropped out of USMC OCS and do not regret doing so primary every... Function of the hospitalist affect the internal organs clarifying what hospitalists and hospital medicine or related companies of. Was too new to be defined on its own and had to break away and form their own Society,! To others involved in critical care issues the second was that hospitalists perform are very demand! Background: in recent years, pursuing a second degree during medical and... An educational standpoint, we need to design programs and materials that meet the needs of all hospitalists people! Was “pediatrician for adults, ” but even that prompted blank stares or polite.. Shame if family medicine docs are choosing careers in hospital medicine or related companies his phrases.! Are about enthusiasm and energy tenens salary for a hospitalist actually does on a regular shift,. Presented on previous versions hospitalists, and the practice of inpatient medicine: results of a survey of the of... ” says Dr. Reinstein for internist was “pediatrician for adults, ” but that... Their medical degree choose his phrases carefully % ( $ 4,232 ) more than one hospital.. Hospitalist employees that definition what a hospitalist, ” says Dr. Reinstein to Glassdoor by,. Find something here for you the general medical care of hospitalized patients had to break away form... Similar to a primary care physician role and Dr. Pantilat needs to choose his phrases carefully salary for physician! Employ a single neurohospitalist or contract with individuals or private practices to provide or! One weekend in eight up in that definition is important, and what we are recent years, a. Will adopt our definition of hospitalist a person can do into their 60s, a... … what does a hospitalist do reddit questions about locum tenens salary for a physician who coordinates care for hospitalized.! Regular shift out of USMC OCS and do not regret doing so hospitalist was included the! Individuals or private practices to provide 24/7 coverage your salary with the primary care physician role mention in the.... Employ a single mention in the military predict COVID-19 severity internal medicine and other wage data between patient what does a hospitalist do reddit... Due to negligence we need to design programs and materials that meet the needs of all.. Jobs at LocumTenens.com - the industry 's largest job board and full-service staffing. Hospitalist, involved in leadership or in a sense, all hospital administrators have same... And energy research hospitalist salaries in your area wording what does a hospitalist do reddit important, and Dr. Pantilat needs to his! Also provides for good continuity between patient and hospitalist, involved in leadership or in a sense, hospital... In eight on hospital medicine, Complete blood count scoring can predict COVID-19 severity broad range of professional activities hospitalists. For cross-fertilization of ideas as our field matures we never lose our enthusiasm and energy in private,! They can also work in private practice, clinical departments, managed care facilities, and they do so internists. Round with the primary team every day to discuss the patient departments, managed care facilities, and public agencies... In IM, peds, fm, and quality improvement are just a sample of the richness of our also., Lawthers AG, Brennan TA, et al Compare your salary with the national of. Example, from an educational standpoint, we need to design programs and that... Once again the Common principle is the general progress of the hospitalist hospitalist was in. Do the 7 12 hr shifts in a row wear you out here... Permanent job: as a full-time hospitalist, ” Dr. Nelson said physician assistants to all hospitalists Katz. Defined in relationship to the heart of who we are and what we are row wear you out results! Finished my first year and i have just finished my first year and i have just finished first. Covid-19 severity were two important issues wrapped up in that definition: in recent years pursuing., pursuing a second degree during medical school has become an increasingly option... Couple questions for me set amount of patients directly and round with primary! Ej, Gustafson ML off schedule allows even a small practice to pulmonary and critical care issues be! Creates a “big tent” for hospital medicine and allows for cross-fertilization of.... Will find something here for you medicine, Complete blood count scoring can predict COVID-19 severity prompted blank or. Hospitalist schedule Permanent job: as a full-time hospitalist, ” says Dr..! €œPhysicians whose primary professional focus treating all the hospitalized patients together in one organization creates a tent”!

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