Nurse Practitioners as Inpatient Providers: A Hospital Medicine Fellowship Program

ospital medicine is the fastest growing medical specialty in the United States. In H2010, the Society of Hospital Medicine estimated that there were over 28,000 practicing hospitalists in the US with some sources calling for a peak of 30,000-40,000. Over 89% of these hospitalists consist of internal medicine residency graduates; however, only 8% of these graduates enter hospital medicine, not nearly enough volume influx to meet the growing national demand. In 2010, the average nurse practitioner (NP) full-time equivalent was only 0.23 per hospitalist physician, even after reports of 16% average NP growth in this field. Additionally, the Association of Academic Medical Colleges predicts a significant physician shortage projected to 2025; assuming current use patterns continue, the hospital inpatient setting is projected to experience the greatest rise in demand for services at 36.6%. One potential solution to the existing and expanding hospitalist dearth is the use of NPs in the inpatient arena. However, many hospitalist groups have struggled to easily incorporate NPs into the hospitalist model.