Not sure about these hospitalists.

[loracs]

A hospitalists is a doctor whose primary professional focus is hospital medicine. Starting in the mid-90’s, these doctors have taken over most aspects of a persons care while in the hospital. As I understand it, this has come about for a couple of reasons. First, primary care providers find it less cost effective to see their patients in the hospital. They can make more in the office. Second, the number of hours interns and residents can work in a week have been restricted in the last decade. These people have provided much of the hospital patient’s care previously. Therefore, we have the development of this new specialty. In effect, “permanent residents” making the rounds everyday, making all kinds of decisions without having every laid eyes or hands on the person before. And if you are in the hospital more than a few days, as stonebenderhas been, then you may see 3 or 4 different hospitalists, each one reading your chart, talking to you for a few minutes and pronouncing you better, worst or the same and by the way, take this new pill/bag o'drugs. 

 

It may not be quite that cavalier, but it feels like it. I want the same person to hear his lungs from day to day and then tell me how he’s progressing. Reading a chart (I hope), listening to his lungs and then saying – “they sound better” does not leave me with a great deal of confidence. “Better than what?” I want to know. 

 

I know he’s getting better. I see it day by day, even thought it has been slow going. What if I didn’t see an improvement? Would the hospitalists know what’s going on? In addition, if she or he is seeing a hundred patients a day, let’s say; how do I know they really have the time to grok his body, his anxiety, his needs, and his health? As serious as pneumonia is, what would I do if it were something more deadly? 

 

Yeah, I’m just not sure I like this new turn of events in health care.

Comments

[cassidyrose.livejournal.com]

I am with you on the hospitalists. Sorry Guy is not getting the continuity of care he needs. I remember these issues with my family members' hospitalizations. It sucks.

We were very fortunate with S. Our medical practice keeps their own pediatrician on staff at Washington Hospital so S. saw the same doc each day he was hospitalized (rather than the ped hospitalsist), including when he was just rooming in with me. So he saw her when he was "well", then each day when he was in the NICU. It really helped us, and it made me much more confident about the quality of care he was receiving. She knew his case intimately and knew us. I truly wish Guy was getting that level of care.

Sending the best of thoughts to Guy and your whole family. I hope he improves and gets out soon.

[tracytreefrog.livejournal.com]

I so understand your doubt and frustration I have been feeling it also. Arrrgghhhhh!

[firecat]

There's a perfect opportunity for a 'hospitalist' to take responsibility for a patient throughout their stay, or at least for a few days at a time. But they don't do it that way, huh? I remember how confused I was about that when the OH's aunt was in the hospital.

I have to say I think it's for the best that interns/residents aren't pulling those killer (literally) shifts any more, but there really has to be continuity of care.