Care Provider Focus: 'Hospitalists' Help Ease Frustration
By William Coyne, M.D.
Cascade Valley Hospital
Grandma is in the hospital and the whole family is anxious to know what is happening. One family member tries to stay with her most of the time, but her physician seems to come when no one is there.
A hospital call, that physician drop-by-and-disappear routine, always has frustrated patients and their families. A patient's personal doctor appears for a few minutes first thing in the morning, or last thing at night. After tweaking orders for medications or tests, the doctor hurries on to the next patient, who may be at another hospital, or waiting in the doctor's office.
There is little time to talk to the doctor during the hospital call, and there may be a big gap between visits when the doctor can't respond immediately to changes in the patient's condition.
Hospital calls have grown equally frustrating for many doctors. They not only extend each workday, but can also mean time wasted commuting between the hospital and clinics.
When the doctor gets tied up in the hospital or stuck in traffic, patients with scheduled appointments in the office have to wait, wasting their own valuable time.
Change is arriving on the heels of a new kind of doctor--one who works entirely at the hospital. Hospital inpatient medical specialists began to appear in the 1990s.
In 1996, a New England Journal of Medicine article picked the name "hospitalists" for this new breed of doctor. It made sense. Internists specialize in internal medicine and cardiologists in the heart. These doctors specialize in hospital medicine. Hospitalists care for patients who are hospitalized, sending regular reports to the patient's personal doctor. Patients return to their doctor when discharged.
Hospitalists have a lot of advantages for patients. Because they are based in the hospital, they are able to spend more time with each patient. They can change medication or order tests--and then follow through to make sure the tests are done quickly.
Hospitalists also admit patients from the emergency department and serve patients who need hospitalization but do not have a personal doctor.
New training rules have reduced the long hours residents once worked in hospitals. Hospitalists are filling that gap. Their familiarity with the hospital workplace culture sometimes enables them to get tests done faster so patients can be treated more efficiently and released faster.
Some studies show that patients treated by hospitalists go home one day earlier than other patients with a bill that's about $900 less. Both doctors and patients have positive opinions of hospitalists, according to other studies.
If you are hospitalized at Cascade Valley Hospital, there may be a hospitalist in your future. CVH recognized the pressures placed on local primary care providers and surgical specialists in trying to balance time between their patients in the hospital and clinic. To aid local providers, CVH has recently implemented its own hospitalist program, hiring Emmanuel Yruma, MD, and William Coyne, MD. Both Drs. Yruma and Coyne are board-certified internal medicine specialists.
Hospitalists are the fastest growing medical specialty in the United States, according to the Society for Hospital Medicine. Their numbers have grown from about 800 in the mid-1990s to about 10,000 today. Experts predict the number of hospitalists will top 25,000 within five years.
Disclaimer: This information is provided for educational purposes only. It should not replace a visit with your health care professional. Call your doctor if you need more information or have additional questions.