Hospitalist

Several weeks ago I started using a hospitalist to manage my patients admitted to the hospital. I have toyed with this idea for several years and am convinced that the benefit to my patients outweigh the disadvantages.

As a solo practitioner I realize that people come to me for personalized care, and that it is important to them that I take care of them – someone they know and are familiar with. This is especially true when they are very sick and in the hospital. That is why I have hesitated for so long to do this.

I have also come to realize, though, that medicine is becoming more complex every year and I can’t do everything. I am very comfortable with almost every aspect of outpatient (office) medicine, but I’m becoming less comfortable with hospital medicine. I admit someone to the hospital only a few times a month, and each time for a totally different problem. I feel I’m falling behind on state of the art hospital medicine. There are many physicians who feel the way I do, and a new specialty has evolved called hospitalists. These physicians see no outpatients, they only manage hospital patients. Once the patient is discharged from the hospital, their primary care physician takes over again.

I am using a group of 2 hospitalists, one of whom I have worked with for years in his former specialty of nephrology (kidney diseases). I have always respected his work, and expect him to continue to practice excellent medicine. The other one has been doing exclusively hospital work for several years now, and has an excellent reputation. These physicians only treat adults, and I plan to continue admitting my own pediatric patients for the foreseeable future. I have spoken with all my patients on the phone during their hospitalization that have been admitted (so far) under the hospitalist service, and am happy to continue doing that. I do have access to the hospital dictations and test results from my office.

I hope that this new arrangement works out to everyone’s benefit. It was a difficult decision to make, but I think it is the right one.