A
new revolution in medicine, these days is the advent of the
hospitalist. The hospitalist, as it sounds, takes care of patients
who need to be hospitalized by their primary care physician.
How it used to be done was that the family or primary care doctor
would often see patients in the morning, in order to "round"
on his or her hospitalized patients before going to clinic.
Often
there would only be one or few patients to see. Many doctors
considered this to be time-consuming, and so physicians that
had experience in treating hospitalized patients were hired
by the hospital. This theoretically left the primary care doctor
to devote more time to see patients in the clinic.
The
impetus for this movement was cost and time efficiency. Most
hospitalists arose from HMO-type settings, which could benefit
by having doctors that could help reduce length of time of hospital
stays were found to be cost effective. Doctors preferring the
outpatient clinic could fit more patients in the morning and
afternoon without having to block time for a trip to the hospital.
Who
are hospitalists? Generally they are physicians trained usually
in internal medicine but may originate from other fields. The
latest surveys show most are young, reflecting the establishment
of this recent type of doctor. There is no specialty (yet) that
trains a doctor to be a hospitalist, but general internal medicine
doctors appear to be the best fit. Most work in day or night
shifts, and usually stays in close contact with the primary
care physician.
How
will the hospitalist movement affect you? The results have been
mixed according to recent surveys.
The
obvious drawback is that a different doctor will be taking care
of you when you are more ill, and not the family doc who knows
you the best. However, by focusing his or her practice in that
setting, the hospitalist may be more adept in dealing with hospitalized
patients and may be more accessible than to physicians outside
the hospital.
We
have a voluntary hospitalist system in my area and Ive found
it helps open some time up for other patients in the clinic.
However I also feel it is important for a primary care physician
to maintain skills in treating sicker patients, so Im currently
assessing myself what are the pros and cons for myself, especially
in patients that are comfortable with me and vice versa.
You
should talk with your own doctor and whether or not they have
a hospitalist system in place. If you are uncomfortable with
another physician taking care of you while you are ill enough
to go the hospital, the hospitalist system may not be right
for you.
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