In the past, a family physician would see his or her patients in the clinic as well as at the hospital. Today, hospitalists are doctors that specialize in and only treat patients in the hospital setting, separating a patient’s hospital care from that of a primary doctor.
Dr. Bruce Waldon, medical director of hospital medicine for Northwest Medical Center in Bentonville, explained the purpose and advantages of a hospitalist during a talk Oct. 24 at Metfi eld.
In the 1970s, physicians averaged 10 patients in the hospital who had stays from eight to 10 days. Today, due to medical developments and better life practices, people are living longer.
Therefore, when they are admitted to the hospital at an older age, their treatment becomes more complicated, Waldon said.
Insurance payments have also changed, he said. Rather than a per diem payment that once was, hospitals are now being paid based on diagnosis.
If a patient has pneumonia, for example, and is in the hospital for two days or 10 days, the hospital gets the same amount from insurance, he said.
As a result, hospitalist care is the fastest growing specialty in medicine, he said.
Most hospitalists specialize in internal medicine, with a small amount practicing family medicine. They admit and care for patients with major medical problems in the hospital, he said.
These doctors act as both
the admitting and attending physicians, and they will provide consultation with surgeons or other specialists needed during a patient’s treatment. Most elderly people who come into the hospital needing surgery, for example, have other issues that must be addressed, such as diabetes, he said.
Hospitalists do not perform surgeries or deliver babies.They also do not have patients in clinics outside the hospital and devote all their time to those in a hospital.
An advantage to this type of practice is that care is more immediately available to patients, and test results are delivered more rapidly if the doctor is already on-site.
These doctors provide greater availability to family members, Waldon said, instead of having them wait for a primary physician to arrive and make rounds.
This type of care aims for more effective treatment,
allowing for a shorter stay.
“If you (the doctor is) in the hospital all the time, they know the buttons to push to get things done,” he said. “Hospitalists and case managers are tied at the hip.”
Clinic-based primary care physicians are also relieved of hospital patients, allowing them more time devoted to outpatient services.
He said some division between primary care and hospitalist care is a potential disadvantage to this practice, if there is a lack of communication between the two. If a hospital stay resulted in some sort of medication change, and the primary physician was not notified the reason for this, that could be an issue. Waldon said most re-admittance situations to a hospital are the result
of medication errors.
At Northwest Medical Center, he said pertinent information is immediately relayed to the primary physician upon admittance
and discharge of each patient treated by a hospitalist.
The center also guarantees patients are seen at least once by the hospitalist following discharge.
Communication with medical professionals is the key, he said: “You need to keep up, honest.”
A patient must feel as they have been treated in a courteous and respectful manner, that they had effective communication with doctors to understand why they are there and that there was ample opportunity to ask questions in the time spent with a physician.
News, Pages 3 on 10/30/2013