Dr. Nathan Frink likes the challenge of working with complex patients, and he finds satisfaction in seeing them get better during their hospital stay. Frink is a hospitalist, a new breed of physician whose practice focuses on providing care for hospitalized patients.

A fast-growing field

"Hospital medicine" is one of the fastest growing medical specialties in the United States. According to the Society of Hospital Medicine, there were about 800 hospitalists in the mid-1990s. Today there are an estimated 20,000 hospitalists, making hospital medicine about the size of gastroenterology or neurology. And that number could rise to 30,000 or more by the end of the decade.

About 75 percent of practicing hospitalists are trained in internal medicine. Others are trained in pediatrics, family practice or internal medicine subspecialties like pulmonology and critical care. A few nurse practitioners and physician assistants also specialize in hospital medicine.

Right there, ready to act

Traditionally primary care physicians spent most of the day seeing patients in the office. They did hospital rounds once or twice a day. If a patient took a turn for the worse, hospital staff paged the physician, who might be in the middle of an office visit.

But the hospitalist is right there, following the patient's progress throughout the day, and able to act quickly in a crisis. In addition, hospitalists have more opportunity to keep up with the newest technology and latest methods of treating acutely ill inpatients.

A rewarding specialty

"I like the pace of hospital medicine," says Frink, who practices at St. Joseph's Hospital, a member of the HealthEast Care System. "And although the relationship is compressed, I enjoy getting to know patients and families."

Hospitalists are responsible for less paperwork than physicians who see outpatients in the clinic. "You deal with lab results and phone calls as they occur," Frink explains. "At the end of a shift, there isn't a pile of messages waiting for you."

He also likes the work schedule: 14 shifts every 28 days. "I enjoy working hard for six or seven days, and then taking a week off," he says.

Thinking of becoming a hospitalist?

Here are some advantages:

• Challenge of caring for complex patients
• Time to assess and focus on patient needs
• Schedule allows for work/life balance.
• No pager call when not working.

Disadvantages

• Short-term relationship with patients
• Weekend, holiday and night shifts