The growth of academic hospital medicine (AHM) over the past 15 years has been shaped by numerous forces. For leaders of academic hospitalist programs to keep pace, it is useful to understand the factors that define the infrastructure of AHM groups.
A survey targeted at leaders of adult and pediatric AHM programs was distributed to 170 group leaders in Spring 2011. The survey consisted of 21 questions addressing academic, clinical and research infrastructure.
Response rate to the survey was 29% (n=50 group leaders, representing 1160 faculty hospitalists). Both adult and pediatric programs were represented, with broad geographic distribution. 66% of programs were universitybased academic medical centers, and 30% were affiliated community hospitals. Programs represented had been in existence a mean of 10.5 years. Regarding academic infrastructure, 60% of AHM groups comprise a separate division within their department. 15% of academic hospitalists had fellowship training. Most hospitalists (82.5%) were on a clinical or clinicianeducator track; 4.4% of hospitalists were promoted on a specific clinicalinvestigator track. Distribution of faculty rankings was as follows: clinical instructor 22.5%, assistant professor 60%, associate professor 9.5%, professor 3.3%, and other 4.7%. Mean time to promotion was 2.1 years from instructor to assistant professor, 6.4 years from assistant to associate professor, and 6.7 years from associate to full professor. Regarding clinical operations, mean group size was 20.5 FTE, and mean work RVU/FTE was 3429 (22004500). Notably 28% of group leaders did not know their clinical productivity data. Only 24% of AHM groups worked exclusively on housestaff services, and 48% of groups work without housestaff > 30% of the time. 72% of AHM groups rely on night coverage mechanisms other than housestaff services, including nocturnists, moonlighters, and faculty shared coverage models. Mean funding from grants or contracts (G/C), including educational and QI funding, was $1.17 million per group, with a wide range (0$15 million, median $60,000). When adjusted for FTE, mean funding from G/C was $88,279/FTE (0$1.4 million, median $3643). 28% of groups (n=14) reported no funding from grants or contracts. The mean number of G/C per group was 4.2, with a median of 2.5 G/C per group, and a mean of 0.29 grants/FTE.
Based on selfreported survey data from leaders of AHM groups, AHM remains a specialty with a majority of faculty at the rank of assistant professor or lower, and a significant amount of clinical responsibility on nonhousestaff services. Support from G/C varies greatly, with over 25% of AHM groups reporting no funded projects; a small number of wellfunded programs create a large discrepancy between mean and median funding levels. Further study to investigate the structural features of highly successful AHM programs would give insight to best practices and help provide benchmarks for leaders in AHM.
To cite this abstract:Amin A, Jaffer A, Lee B, Brotman D, Seymann G, Glasheen J. The Structure of Hospital Medicine Programs at Academic Medical Centers. Abstract published at Hospital Medicine 2012, April 1-4, San Diego, Calif. Abstract 97681. Journal of Hospital Medicine. 2012; 7 (suppl 2). https://www.shmabstracts.com/abstract/the-structure-of-hospital-medicine-programs-at-academic-medical-centers/. Accessed July 22, 2019.