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Hospital Medicine: A
Market Overview
January 2014
Mid to late 1990s:
Hospitalists primarily trea9ng
unassigned pa9ents
Late 1990s to early 2000s: Hospitalists move into 24/7
coverage, resident training and and early leadership roles
Mid to late 2000s: Hospitalists move into periopera9ve care, comanagement with a variety of subspecial9es, systems redesign
and quality improvement
Late 2000s and beyond: Hospitalists focus on readmissions, begin admiFng the pa9ents of all
subspecialists, move beyond medical wards to ensure con9nuity and quality of care, and take key roles in
implemen9ng health care reform
The hospitalist story
The growth of hospital medicine
0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Number of hospitalists prac2cing in the U.S.
Source: The Society of Hospital Medicine
Training • 74% Internal medicine • 12% FPs • 7% Pediatricians • 5% Med/Peds
Hospitalist Demographics • Average age: 44 • 70% male/30% female • On average, hospitalists have been prac9cing hospital medicine for 7.25 years
• 57% of hospitalists have been working in their current job for 4 or less years
Employer Demographics • Average group size 16 • Average hospital 298 beds • 41% at teaching hospitals • Nearly half (47%) work for hospitals or hospital corps. • 17% work for a local hospitalist group
• 15% work for a na9onal hospitalist mgmt. co.
• 10% work for a university/medical school
Work Schedule • Hospitalists spend most of their 9me (80%) on pa9ent care
• 50% work block coverage (7 days on, 7 days off)
• 6% work only nighFme shi_s
Who are hospitalists?
Scripts written per week by hospitalists
Therapy Rx per Week
Addic9on Medicine 11.40
An9coagulants/An9platelets 20.38
An9microbials/An9bio9cs 22.71
Cardiac Care 28.09
COPD/Asthma 9.87
Cri9cal Care Drugs 9.87
Diabetes 24.62
Estrogen Products 4.09
Euvolemic Hyponatremia 3.68
GI Care 24.44
Neurologic Agents 15.85
Osteoporosis Agents 4.96
Pain Management 42.08
Psychiatric agents 29.51
Rheumatoid Arthri9s 3.63
Sexual Dysfunc9on Agents 4.01
Stroke/t-‐PA 3.33
Condi9ons treated • 75% of pa9ents are treated for acute care (heart aeacks, strokes, GI bleeds, severe wounds, diabetes, severe infec9on, etc.)
• 25% of pa9ents are treated for primary care (upper respiratory infec9ons, arthri9s, headaches, sleep disorders, anxiety, etc.)
Hospitalists treat 4.3 different diseases/condi9ons per pa9ent
Diseases/conditions treated by hospitalists
Hospitalists commonly rewrite prescrip9ons pa9ents are already taking • On average, hospitalists rewrite prescrip9ons for more than one third (37%) of their pa9ents
During an average shi_, Today’s Hospitalist readers write 39 scripts • Scripts per shi_ for prescrip9on drugs: 28 • Scripts per shi_ for OTC drugs: 11
Hospitalist prescribing patterns
Hospitalists not only prescribe lots of drugs, but they ac9vely educate pa9ents to gain compliance with drug therapy
On average, hospitalists use 4.5 different methods to enhance pa9ent compliance with drug therapies • 96% educate pa9ents on the medical condi9on • 88% clearly explain instruc9ons and importance • 75% ask pa9ents if instruc9ons are understood • 73% Use or provide pa9ent educa9on material • 36% Follow up with pa9ents
Hospitalists are opinion leaders for pa9ent care and drug therapies • 72% say they are frequently sought out for advice on pa9ent care issues
• More than half (57%) say they are frequently sought out for input on the proper drug to prescribe
More than just prescribing
Prescription-writing beyond the wards
Periopera9ve care
ICU care
Universal admieer
Hospitalists’ roles beyond the wards
Medical Wards
Quality improvement
Commieee work
Informa9cs Leadership
ACOs
Hospitalists and pharmaceu9cal reps
Only 30% of hospitalists say they
regularly see a pharmaceu9cal rep
Most say they see detailers less than
once a week
Reaching hospitalists
Source: BPA statements (Today’s Hospitalist, Hospitalist News, The Hospitalist) and published rate sheets (ACP Hospitalist)
Circulation overview of publications for hospitalists
32,372
31,870
24,588
22,738
0 10,000 20,000 30,000 40,000
Today's Hospitalist
ACP Hospitalist
Hospitalist News
The Hospitalist (SHM)
Source: BPA statements (Today’s Hospitalist, Hospitalist News, The Hospitalist) and published rate sheets (ACP Hospitalist)
Circulation overview of publications for hospitalists
32,372
31,870
24,588
22,738
0 10,000 20,000 30,000 40,000
Today's Hospitalist
ACP Hospitalist
Hospitalist News
The Hospitalist (SHM)
Which publication do hospitalists
actually ask for?
22,361
6,040
0
0
0 10,000 20,000 30,000 40,000
Source: BPA statements (Today’s Hospitalist, Hospitalist News, The Hospitalist) and published rate sheets (ACP Hospitalist)
Circulation overview of publications for hospitalists
32,372
31,870
24,588
22,738
0 10,000 20,000 30,000 40,000
Today's Hospitalist
ACP Hospitalist
Hospitalist News
The Hospitalist (SHM)
Which publication do hospitalists
actually ask for?
22,361
6,040
0
0
0 10,000 20,000 30,000 40,000
Which publication is reaching
hospitalists?*
30,021
NA**
16,934
16,794
*Excludes residents and nonphysicians **Circula9on breakdown not publically available
0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Today’s Hospitalist Circulation Growth
Vvvvvf
Source: June 2013 Kantar Media study of 188 hospitalist-‐based internists
“Do-not-receive” rates in Kantar Media’s syndicated study
Do not receive�
Hospitalist News� � 47%�
ACP Hospitalist� � 59%�
Today’s Hospitalist� � 71%�
The Hospitalist� � 77%�
FACT: 50% to almost 80% of the Kantar surveyed physicians do not receive any hospitalist publica9on. QUESTION: How reliable and sta9s9cally significant is this sample?
No. 4/4 readers�
30�
23�
21�
17�
Readership: Read all or most issues (3 out of every 4 issues)
% Read�
Today’s Hospitalist� 70.2%�
Source: June 2013 independent study of nearly 1,000 hospitalists
The Hospitalist (SHM)� 47.7%�
ACP Hospitalist� 41.1%�
Hospitalist News� 25.1%�
Journal of Hospital Medicine� 20.8%�
Major segments of Today’s Hospitalist readers can’t be reached by other publica9ons: • 48.5% don’t belong to the Society of Hospital Medicine • 52.0% don’t belong to the American College of Physicians
What does it cost to reach 1,000 hospitalists?*
Publication�Total
circulation�Hospitalist circulation*�
Page rate�
Cost per 1,000
readers�
�Today’s Hospitalist� 32,372 30,021 $4,775 $159
�Hospitalist News� 24,588 22,777 $4,280 $250
�The Hospitalist� 22,738 15,216 $5,345 $351
�ACP Hospitalist** � 31,870 NA**
* Excludes residents and nonphysicians **Circula9on breakdown not publicly available Source: BPA statements (Today’s Hospitalist, Hospitalist News, The Hospitalist) and published rate sheets (ACP Hospitalist)
Digital reach Our weekly e-‐mail newsleeer is opened by nearly 25% of recipients (between 4,000 and 5,000 opens per week).
Survey response rate The annual Today’s Hospitalist Compensa9on & Career Survey has response rates of nearly 1,000 hospitalists.
Web site Nearly three-‐fourths of Today’s Hospitalist readers (72.2%) say they regularly visit the Today’s Hospitalist Web site.
Reader engagement metrics
Hospitalists and digital media
Nine in 10 hospitalists own a
smartphone (85%) or a tablet (50%)
63% of our readers use their smartphone in clinical work; 20%
use a tablet.
46% of our readers use social media to network with other
hospitalists
Innovative ways to reach hospitalists
Today’s Hospitalist Magazine
Digital, single-‐sponsor
newsleeers
Sponsored e-‐mail blasts
Special report
Clinical case video
Online resource centers focusing on clinical condi9onal
work
Innovative ways to reach hospitalists in this market
Jeffrey S. Berman Be Media Partners LLC
Phone 866.695.3870, ext. 12 Fax 215.249.4741
Edward T. Doyle Editor & Publisher, Today’s Hospitalist
Phone 215.997.9650 [email protected]
For more information
