Implementing hospital medicine a challenge for critical access hospitals Only a decade ago, some questioned the benefits and sustainability of hospital medicine (HM). Today, over 80 percent of hospitals with 200 or more beds have an HM program, and most hospitals with fewer than 200 beds either have an organized HM program or are seeking to develop one. For critical access hospitals (CAHs), the progression toward organized HM services has been a bit more deliberate. Indeed, the executive teams at most CAHs struggle with the issue of HM implementation on a daily basis. Community size, difficulty in provider recruitment, slower PCP acceptance, and more challenging ROI achievement are some of the more common reasons for less HM use in CAHs. There are, however, strong drivers for CAHs to implement the HM model, such as: the loss of patients to larger regional institutions, resulting in a steady, sustained decline in CAH patient volume, local PCPs’ displeasure in caring for marginal cases that could be managed locally if there were a dedicated physician with the requisite skill set present and available, and patients’ desire to be treated at their community hospital to receive care from trusted and familiar healthcare providers—and to be…
