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What is a Hospitalist?

Who is the doctor? Why isn't my physician coming to see me in the hospital?

Nov 22, 2006 Kathy Quan

The high cost of medical care and demands from an aging population have forced many changes in the health field. The hospitalist is an emerging career path for MDs.

When did this happen?

Hospitalists began to appear about ten years ago, but are rapidly becoming much more widely used. Physicians have seen their salaries decline significantly over the past ten years with the implementation of managed care. Along with this, physicians have begun to cut way back on their hours and on-call responsibilities.

Today, many physicians use hospitalists to care for their patients when they visit emergency rooms or are admitted to the hospital. The hospitalist communicates with your primary physician, but handles your care during time spent in the hospital.

More Familiar with the hospital

Hospitalists are often much more familiar with the hospital and its systems and functions. Because the hospital is the primary site of their practice they are usually able to spend more time with patients than would your regular physician making "rounds" of all of his patients on his lunch hour, or on his way home after office hours.

Who are hospitalists?

Hospitalists complete med school and usually specialize in internal medicine, family practice or pediatrics. They might be members of a medical practice, or they may cover for one or several physicians independently. They might even be former students of your physician if s/he has taught in a local medical school. Physicians looking to reduce their workload may choose to become a hospitalist and give up their regular practice.

Hospitalists may sometimes be hired to handle on-call services for your physician after hours or weekends and holidays. So you may have contact with them if you need assistance after hours.

Who follows up?

Usually the only time you would be seen by the hospitalist is during and ER visit or hospital stay. Most do not provide follow-up care or have their own practice.

Be Proactive

To ensure you have the best care, you should always carry a list of :

  • your current medications

  • allergies

  • medical conditions and on-going treatments

  • physicians names and phone numbers.
At Discharge

If you visit the emergency room or are admitted to the hospital, ask for a complete discharge summary upon discharge to take to your physician. Insist that the hospitalist communicate with your physician regularly as well as any consultants s/he calls in to see you. After you have been discharged, make sure to call for a follow-up appointment with your physician. Take with you any new or changed medications, and any other new orders for diet, therapy or follow-up care.

What about home health care?

If you need home health care such as a visiting nurse or therapist, be sure the hospitalist orders the care and that your physician is notified so s/he can attend to oversight of this care. The hospitalist won't continue to give orders beyond the initial order.

The copyright of the article What is a Hospitalist? in Health Field is owned by Kathy Quan . Permission to republish What is a Hospitalist? in print or online must be granted by the author in writing.

Comments

Aug 20, 2008 10:40 AM
Guest :
i think this is a very bad idea.Under normal conditions a nurse practioner can handle most office follow-ups.The patients who are in the hospital are sicker and require more of the physcians experience .It seems that this system is backwards.
Aug 29, 2008 10:55 AM
Guest :
That is why it IS a physician handling those that are seen in ER, etc. - a hospitalist has went through medical school!
Sep 4, 2008 12:02 PM
Guest :
my cousin is an hospitalist. he is an awsome dr. i feel this give our familey practice dr.'s more time with the patients in their office, instaed of worrying about going to the hospitals.
Sep 10, 2008 1:34 PM
Guest :
...one of your so called 'hospitalist' was responsible for the death of my wife- 3 hr absence in the ER and followed the wrong protocal for diagnosis...not sure the intent stated here is being met in some locales
Sep 18, 2008 1:30 PM
Guest :
Doesn't this defeat the purpose of going through the research necessary to choose a qualified physician to be your primary care doctor. At the time you need your PCP most they fluff you off to some one else who could care less if you walk or crawl home.

Your PCP knows your meds, and your history, and should be more qualified to oversee any treatments or medications you are receiving in the hospital. If I understand the paragraph above, it is up to us to make some other staff member aware of what our history is, what meds we are on, what our family history is, what we are alergic to, etc., etc..

Someone else mentioned that "this is a very bad idea". Actually it is an abomination, and a wholly unjustifiable defiance of the patients' interests and welfare.

I have spent the past year and three quarters undergoing chemotherapy and radiation ending in a bone marrow transplant, at the same time making sure that my oncology team kept my primary care Physician in the loop at all times concerning my treatment and overall health. I am just learning now that my PCP started this "hospitalist" BS about six months ago, and having a reason to visit his office today, read a note on his door telling his patients about this "hospitalist" garbage, ending his note with a statement saying if his patients didn't like it -- they could find another physician who would see patients that were hospitalized (providing of course if those MDs were taking new patients). What a bunch of BS. I guess they need more time to play golf or take vacations that their patients and their insurance companies pay for.

Get real --- These MDs in private practice just don't care for their patients, and like most politicians, are in the game for the money and freebies. -- DMC - Massachusetts
May 7, 2009 9:09 AM
Guest :
Hows this one....I was recently hospitalized and was seen by the ER doctor and my surgeon. Just recently got a billed for "hospital care" for $759.00. After many calls I am told it was the hospitalist that "spoke with me, took a complete history and did an exam" Are you kidding me? He never even stepped into my room. Fraud alert!! Imagine the people who are out of it and don't remember who came to see them. I was only there for about 8 hours and sent to another hospital. Seems to me the Health Care crisis is being caused by the medical field. What happened to ethics???
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