Comparison of Five Otolaryngology Hospitalist Programs: A Mixed-Methods Study

Introduction: Hospital-based otolaryngology (HBO) is an evolving paradigm, first implemented at the University of California San Francisco in 2011. At present, there are five dedicated HBO programs in the United States that have been functioning for at least two years. This study describes these programs and may serve as a resource to otolaryngologists, departments, and hospital leadership exploring implementation of this model at their institutions.

Methods: This study was conducted from November 2024 to January 2025 and includes structured surveys and interviews with all HBO providers from institutions with established programs (two years or longer). Data were collected using a standardized questionnaire and analyzed with descriptive statistics and thematic analysis. Variables assessed include provider background, program setting, practice patterns, institutional support/funding, clinical experience, teaching involvement, leadership opportunities, provider satisfiers/dissatisfiers, and perceived benefits of the program.

Results: Eight HBO providers from five programs were interviewed. All practices are in urban, academic, and tertiary or quaternary care settings. All programs were established with the goal to improve response to otolaryngology daytime consults and to avoid faculty schedule disruption. Seven of eight HBOs are salaried; compensation is funded by the hospital (4) or department (3). All HBOs participate in teaching and scholarship. Most are involved in hospital committees (5/8) and leadership positions (6/8). Provider satisfiers/perceived benefits include multi-disciplinary collaboration, improved patient care, and enhanced resident education. Provider dissatisfiers/challenges include lack of support/understanding of the role, clinical unpredictability, cross-coverage, and coordinating outpatient follow-up.

Conclusions: Well established HBO programs share commonalities. Provider experiences offer practical insights into building sustainable and effective hospital-based otolaryngology practices.