“Doctor, what exactly is a hospitalist?”
When the hospitalist system was first introduced in Korea as a pilot program in 2016, inpatients would often tilt their heads and ask this. Whenever they did, I would answer like this.
“It refers to a physician who doesn’t see outpatients and instead specializes in caring only for hospitalized patients. We’re the attending physicians on the ward who take responsibility for the entire process from admission to discharge. When needed during a hospitalization, we also coordinate by contacting subspecialists so patients can receive specialized treatment or surgery.”
Back then, patients admitted to university hospitals often found it difficult to see a doctor except during one or two professor rounds a day. Residents in training were also overwhelmed with heavy workloads, so it wasn’t enough to ease patients’ discomfort or caregivers’ anxiety.
That’s why the hospitalist system was introduced: to have attending physicians stationed on the ward who continuously monitor patients’ conditions and respond immediately, reducing risks caused by a “lack of doctors.” In advanced countries such as the United States and Japan, it began 20–30 years ago and has long since become established.
In English, an inpatient-dedicated physician is called a hospitalist. In other words, it means a doctor who stays in the hospital. When I introduced myself as a hospitalist, patients or caregivers would ask back, “A hospice doctor?” Hospice refers to caring for terminally ill patients, so some patients would wonder why they were receiving hospice care. The hospitalist system was that unfamiliar—and that groundbreaking.
Before we knew it, 10 years had passed. In the meantime, large hospitals began actively using hospitalists while promoting themselves as “specialist-centered hospitals,” and the government encouraged the system by providing incentives to tertiary hospitals that employ hospitalists. When a healthcare gap emerged due to the mass resignation of residents the year before last, hospitals with hospitalists were able to provide inpatient care relatively stably.
The atmosphere on the wards has changed, too. The phrase I hear most often from patients is surprisingly simple.
“It puts my mind at ease knowing you’re always nearby on the ward.”
Checking symptoms day by day, explaining test results, and carefully walking patients through the treatment plan ahead—this process may seem obvious, but for patients and caregivers it builds trust that “someone is always here taking care of me.” Each time, I feel proud that I chose this work.
When I work weekends, what I see on the ward is a bit different. That’s because I care not only for my own patients, but also for the patients of my colleague physicians I work with during the week. Before the weekend, I receive updates on patients’ conditions from my colleagues and then check, one by one, everything that happens over the weekend.
“Hello. I’m the attending physician on call today, so I came by to see how you’re doing.”
At first, both patients and caregivers are briefly taken aback by a visit from an unfamiliar doctor. But as I ask about their condition and continue with a calm explanation, their expressions soon brighten. And by the time I’m about to leave after rounds, I hear, “Thank you for coming even though it’s the weekend and for taking such thorough care of me, just like my own attending physician.” It’s a single sentence that melts away the fatigue of weekend call.
In that moment, I feel the reason hospitalists exist once again. I realize that the essence of our work is the sense of responsibility and pride in guarding the ward so that medical care doesn’t stop—regardless of day or night, weekday or holiday—and so that patients’ safety is never compromised.
Currently, about 360 hospitalists are working at medical institutions nationwide. Considering the scale of our healthcare system, that number is far from sufficient. A couple of years ago, the Korea Patient Organization Alliance surveyed about 1,000 patients about the hospitalist system; responses showed high satisfaction but low awareness. Because there are so few hospitalists, many patients don’t know the system well, but among those who have received care even once, more than 8 out of 10 said they would want to be treated by a hospitalist again. It seems to be gradually taking root as an essential role.
It may sound like a funny aside, but there’s one more thing patients truly don’t realize.
The goal of a hospitalist is to help hospitalized patients recover their health and be discharged so they can return to everyday life as much as possible. Meeting us—who work only on the ward—means the patient’s condition worsened again and they were admitted. So when a patient is discharged, this kind of conversation happens.
“Thanks to you, Doctor, I’m feeling better. I’ll definitely see you again next time.”
“It’s better if you don’t see me. Take good care of your health after discharge, and you must not be hospitalized again. Let’s never meet again.”
Kyung-tae Young, MD
President, Korean Society of Hospital Medicine (Chair, Department of Hospital Medicine, Yongin Severance Hospital, Yonsei University College of Medicine)
〈Editor’s Note〉
A hospitalist is a physician who stays on the ward and provides close, continuous care for hospitalized patients. The hospitalist system, which began as a pilot program in 2016, transitioned to a full program in 2021 and marks its 10th year this year. “Hospitalist Diary” records the small moments these physicians accumulate day by day as they meet patients on the ward, treat them, and discharge them. From patients and caregivers to other medical staff—and even candid reflections about the hospitalists themselves—this series aims to share with readers the “stories of real people” that unfold inside the hospital. With support from the Korean Society of Hospital Medicine.
