What’s a Hospitalist Anyway? A Guide to New and Old Medical Titles

Medical care has changed a lot since Dr. Kildare and Ben Casey were tending to patients. When you visit a medical office or hospital these days, you’re likely to come across health professionals wearing badges with titles that are new to you. Who are these people, anyway? What’s their training, and what do they do?

Here’s a crib sheet of familiar and not-so-familiar titles to help you through the medical maze.

Physicians and Surgeons

Degree: M.D. (doctor of medicine).

D.O. (doctor of osteopathic medicine).

What they do: Both M.D.s and D.O.s examine patients, prescribe medication and diagnose and treat illnesses. D.O.s place special emphasis on the body’s musculoskeletal system. Primary care doctors generally specialize in internal or family medicine or pediatrics. Specialists focus on a particular branch of medicine or surgery, such as dermatology, oncology or radiology.

Where they work: Private offices, clinics, health care organizations, hospitals, VA hospitals, outpatient centers, and colleges and universities.

Training: Both M.D.s and D.O.s attend four years of college followed by four years of medical school. After medical school almost all of them enter a residency program for specialty training, which lasts three to eight years depending on the specialty.

Licensing examination: Yes.

Geriatricians

Degree: M.D. or D.O.

What they do: Take care of older adults, especially those with multiple health problems.

Where they work: Private offices, hospitals, nursing homes, VA hospitals, assisted living facilities.

Training: One year of post-residency training following a residency in internal medicine or family medicine, or geriatric training as part of an approved residency program.

Licensing examination: Certification in geriatrics. 

Geriatric Psychiatrists

Degree: M.D. or D.O.

What they do: Diagnose, treat and prescribe medications for problems such as dementia, depression and anxiety in older adults.

Where they work: Private offices, hospitals, nursing homes, VA hospitals, assisted living facilities.

Training: Four years of approved residency training in general psychiatry followed by one year of post-residency training in geriatric psychiatry.

Licensing examination: Must pass the certifying exam for general psychiatry before taking the exam for geriatric psychiatry. 

Hospitalists

Degree: M.D. or D.O.

What they do: Assume the medical care of patients during hospital stays; they also teach and do research.

Where they work: Hospitals.

Training: Usually trained in internal medicine, pediatrics, family practice and obstetrics. Academic medical centers have recently begun to develop hospitalist residencies and post-residency programs.

Licensing examination: Certification in primary specialty. 

Patient Navigators

Degree: No.

What they do: Help people make their way through the complexities of the health care system. Coordinate appointments, arrange translation services if necessary, sort out paperwork, see to transportation and locate child or elder care. Originally launched to help medically underserved people with cancer, the American Cancer Society patient navigator program provides services free of charge. Some hospitals have navigator services for other medical conditions. Private agencies charge a fee for a variety of services.

Where they work: Generally, hospitals and health care facilities.

Training: The American Cancer Society provides training for patient navigators in collaboration with the National Cancer Institute.

Licensing examination: No. 

Physician Assistants

Degree: P.A. (physician assistant).

What they do: Provide medical services under the supervision of a physician.

Where they work: In many settings, including private practices, hospitals, nursing homes and surgical centers.

Training: Most have a bachelor’s degree and three years of health care experience before they enter a P.A. program, which lasts on average just over two years.

Licensing examination: Yes. 

Registered Nurses

Degree: A.D.N. (associate degree in nursing).

B.S.N. (bachelor of science in nursing).

What they do: Examine patients and administer treatment and medications. Provide advice and emotional support.

Where they work: Hospitals, patients’ homes, community centers, workplaces and schools.

Training: May choose either a two-year associate degree offered by community colleges or a four-year bachelor of science in nursing offered by colleges and universities.

Licensing examination: Yes.

Advanced Practice Registered Nurses

An umbrella term for R.N.s who have a master’s or doctor’s degree, have met advanced practice requirements and provide direct patient care.

There are four categories of APRNs with different certifications:

NP (nurse practitioner)

CNM (certified nurse midwife)

CNS (clinical nurse specialist)

CRNA (certified registered nurse anesthetist)

What they do:

Nurse practitioners provide primary health care services, prescribe medication and diagnose and manage common medical conditions, infections and injuries.

Certified nurse midwives provide gynecological and prenatal care to healthy women, deliver babies and do follow-up postpartum care.

Clinical nurse specialists provide care in a wide range of specialty areas. They also work in research, education and administration.

Certified registered nurse anesthetists administer anesthesia in settings ranging from hospital operating rooms and dental offices to outpatient surgical centers.

Where they work: In various settings, including private offices, VA facilities, hospitals, community clinics, HMOs, schools and nursing homes.

Training: Advanced, graduate-level training.

Licensing examination: Yes. 

Licensed Practical Nurses

Training L.P.N. (licensed practical nurse).

What they do: Under the direction of an R.N. or M.D. provide nursing care, administer medication, and help with bathing and personal hygiene.

Where they work:: Hospitals, nursing homes, clinics and home health care.

Training: Most have a high school diploma before they enter a one-year training program offered by vocational or technical schools or community or junior colleges.

Licensing examination: Yes. 

Physical Therapists

Degree: P.T. (physical therapy) or D.P.T. (doctor of physical therapy).

What they do: Diagnose and treat both adults and children with medical problems or conditions that limit the ability to move.

Where they work: Hospitals, clinics, private offices, schools, nursing homes.

Training: A college degree followed by a two-year master’s degree program or three-year doctoral degree program. The majority of programs offer a D.P.T. degree.

Licensing examination: Yes. 

Geriatric Care Managers

Degree: No.

What they do: Locate, plan and supervise care of older adults whose families live too far away to help with day-to-day care and decisions.

Where they work: Patients’ homes, hospitals, nursing homes.

Training: Typically have degrees in social work, nursing, counseling or gerontology before becoming geriatric care managers.

Licensing examination: No, but certification programs are required for membership in the National Association of Professional Geriatric Care Managers. These include CMC (care manager certified), CCM (certified case manager), C-ASWCM (certified advanced social worker in case management) and C-SWCM (certified social work case manager). 

Home Health Aides

Degree: No.

What they do: Help older, infirm or convalescent patients live in their own homes instead of health care facilities by providing health-related services.

Where they work: In patients’ homes.

Training: Some home health agencies provide classroom training, and others rely on on-the-job training. Federal law requires aides to pass a competency test if their agency is certified by Medicare.

Licensing examination: Some states require licensing. Aides can also participate in a voluntary home care certification program.

“ In case you were wondering: In many hospitals, medical and nursing students traditionally wear short white lab coats until they graduate and receive their professional degrees, at which time they don long coats.”