Abstract
Pediatric Hospital Medicine (PHM) is a young subspecialty with practice models that continue to evolve. To inform program and workforce planning, it is essential to understand the current state. This study sought to delineate current work models for PHM. In the spring of 2021, we conducted a survey-based cohort study of individuals identifying as PHM program leaders. Individuals were invited based on membership in the 3 PHM sponsoring societies. Additional respondents were recruited through society listservs. One hundred ninety-eight program leaders responded to the program model survey. One-half covered only community sites, 21.2% covered only university sites, and 21.2% covered both university and community sites. Programs provided a diverse set of services, with community sites covering more services, including newborn nurseries, emergency department consultation, and delivery room care. Median total hours for 1.0 clinical full time equivalent were 1849 across all sites, 1800 at university-only sites, and 1900 at community-only sites. Inpatient floor patient caps, when present, were higher for resident covered versus noncovered teams (16 vs 13). Similarly, back-up activation was higher for resident-covered teams (15-16) than noncovered teams (12-13.5). Current data on clinical work hours for pediatric hospitalists are consistent with recent, smaller studies, suggesting that the current national median for a 1.0 FTE clinical position at university-based sites is 1800 annual hours. Community hospitalists often work more clinical hours than university sites and more commonly provide a broader range of service lines. More studies are needed to explore the differences between community and university site work models.
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