Roles considered important for hospitalist and non-hospitalist generalist practice in Japan: A survey study

Abstract

Abstract Background: An increased focus on quality and patient safety led to the evolution of the hospitalist specialty. The number of hospitalists, who cover ward and outpatient care, is on the rise in Japan. However, it is unclear what roles hospitalists themselves consider important in their practice. Therefore, this study aimed to investigate what hospitalists and non-hospitalist generalists in Japan consider important for the practice of their specialty. Methods:This was an observational study that included Japanese hospitalists (1) currently working in a general medicine (GM) or general internal medicine department and (2) working at a hospital. Using originally developed questionnaire items, we surveyed what they think are important to hospitalists and what are important compared to that for non-hospitalist generalists. Results: There were 971 participants (733 hospitalist, 238 non-hospitalist) in the study. The response rate was 26.1％. Both hospitalists and non-hospitalists ranked evidence-based medicine as most important for their practice. Hospitalists ranked diagnosis and patient management as the second and third most important roles for their practice while non-hospitalists ranked patient management and elderly care as second and third. Conclusions: This is the first study investigating what roles Japanese hospitalists consider important and compare those to that of non-hospitalist generalists. Many of the items that hospitalists responded to that they actually consider important were those that hospitalists in Japan are actually working on within and outside of academic societies. We found that diagnostic medicine, and quality and safety are likely to be evolved by hospitalists because they specifically emphasized them, while the care of the elderly is an issue that hospitalists should be more concerned about. Future expected research includes proposals on how to further enhance items that hospitalists emphasize and should focus on, as well as international comparisons regarding the items.