Background: Effective collaboration between hospitalists and subspecialists is crucial for high-quality inpatient care. Nevertheless, research on interprofessional communication and decision-making in South Korea remains limited, partly reflecting the early stage of the country’s hospitalist system. This study aimed to investigate differences in perceptions regarding conflicts, communication, and care continuity between hospitalists and subspecialists.

Methods: A comparative survey was administered to hospitalists and subspecialists across six tertiary hospitals using identical items assessing communication, decision-making agreement, urgency-related information sharing, continuity of care, workload, and overall service evaluation. Responses included five-point Likert scale items and multiple-choice items allowing multiple responses. Between-group differences were analyzed using Mann–Whitney U tests for ordinal variables.

Results: Conflict experiences were reported by 9.09% of subspecialists and 54.29% of hospitalists (Figure 1A), with a significant between-group difference (U = 480, p < 0.001). Specialists cited communication difficulty (27.27%) as the main reason for conflict, followed by disagreement on treatment, colleague relationships, and unclear responsibilities (13.64% each). Hospitalists most often reported disagreement on treatment (30.36%), followed by communication difficulty (23.21%) and patient dissatisfaction (14.29%) (Figure 1B). Both groups reported positive experiences with smooth communication, agreement on treatment plans, real-time information sharing, and continuity of care (Figure 2A–D). However, Mann–Whitney U tests showed statistically significant differences between the groups for all four items (p < 0.001, p < 0.001, p = 0.004, p = 0.029, respectively), indicating that subspecialists generally rated these aspects more favorably than hospitalists. Hospitalists preferred EMR-based consultations or phone calls, whereas subspecialists favored in-person discussions or text messages; preferences for other methods were relatively evenly distributed (Figure 2E). Both groups agreed that timely communication was critical when a patient’s condition changed or when deciding on tests/procedures (Figure 2F). Hospitalists reported higher involvement across all aspects in inpatient care decisions, while subspecialists mainly participated in decisions about tests and procedures (Figure 2G).

Conclusions: Both groups reported generally positive experiences, but differences in perceptions highlight areas for improvement. Hospitalists experienced more conflicts, mainly related to treatment decisions, whereas subspecialists cited communication as the primary issue. Targeted strategies to enhance interprofessional communication, clarify roles, and standardize decision-making could further optimize collaborative inpatient care in South Korea’s early-stage hospitalist system.

IMAGE 1: Figure 1. Conflict experience and reasons for dissatisfaction between hospitalists and subspecialists (*multiple responses allowed).

IMAGE 2: Figure 2. Comparison of hospitalists’ and specialists’ perceptions of communication, decision-making, and continuity of care (*multiple responses allowed).