Characteristics of Young Family Physician Hospitalists

• Career Choice
• Family Physicians
• Health Workforce
• Hospitalists

The specialty of hospital medicine is now more than 20 years old in the United States.¹ Most hospitalists are internists and internal medicine subspecialists but a small proportion are family physicians.² We sought to quantify the proportion of young family physicians who are becoming hospitalists and to describe their characteristics, comparing them to young family physicians who are not hospitalists.

We used data from the 2016 Family Medicine National Graduate Survey, which was administered to all board-certified family physicians 3 years after they completed residency in 2013.³ The survey instrument included respondent demographics and questions on type of practice, work schedule, income, and work satisfaction. This study was approved by the American Academy of Family Physicians Institutional Review Board. The χ² and k-sample tests were used to assess statistical significance.

Response rate was 67.8% of the 3051 doctors surveyed, yielding a sample size of 2069, of whom 2034 were in active patient care. Of those in active patient care, 181 (8.9%) of the respondents stated they both did not provide outpatient continuity care and principally self-identified as hospitalists. Men were almost twice as likely as women to be hospitalists (11.9% vs 6.6%, P < .001). On average, hospitalists worked more hours per week than nonhospitalists (64.2 hours vs 53.6 hours, P < .001). Many more hospitalists than nonhospitalists reported that they worked over 60 hours per week (46.4% vs 29.1%, P < .001). Median income was $250,000 for hospitalists versus $185,000 for nonhospitalists (P < .001). Hospitalists were more likely to be satisfied or very satisfied with their principal practice overall than their nonhospitalist peers (92.8% vs 84.3%, P < .01). (see Table 1.)

If these findings are generalizable, interest in hospital medicine among family physicians may grow beyond the almost 9% seen in this survey. Over half of graduating family medicine residents report more than $150,000 in educational debt.⁴ The higher compensation of hospitalists might disproportionately attract family medicine graduates with large educational loans to repay. Hospital medicine's fixed hours and lack of on-call responsibilities might also be attractive to graduating residents. If a larger proportion of family physicians become hospitalists, primary care physician shortages might be exacerbated.

We conclude that the respondents in this sample of young family physician hospitalists were significantly more likely to be male, work longer hours, be better paid, and be more satisfied with their work than their nonhospitalist peers in family medicine.

• Received for publication March 1, 2018.
• Revision received May 7, 2018.
• Accepted for publication May 21, 2018.