| It's an emerging trend, and one that many | | | | in the gaps. |
| patients find confusing and uncomfortable: | | | | |
| their primary doctor doesn't visit them in | | | | When a patient is discharged from the |
| the hospital any more and doesn't manage | | | | hospital the hospitalist relinquishes care |
| their hospital care. | | | | back to the PCP. If communication has not |
| | | | been good, the primary care physician often |
| Primary care doctors are increasingly turning | | | | has little knowledge of what the patient |
| the care of their hospitalized patients over | | | | experienced in the hospital. Records are |
| to specialists called "hospitalists." | | | | frequently slow to follow the patient, so on |
| | | | the first follow-up visit the office-based |
| The hospitalist is a hospital-based doctor | | | | doctor may have scant information. |
| who does not see patients in an office-based | | | | |
| practice. He or she manages the care of | | | | Without adequate information the PCP |
| patients only while they are in the hospital, | | | | frequently makes adjustments to treatment |
| turning them back over to their regular | | | | plans and medications that are counter to the |
| physicians when they are discharged. During | | | | treatment plans initiated in the hospital. |
| the time a patient is in the hospital the | | | | |
| hospitalist is responsible for all decisions | | | | How To Work With A Hospitalist |
| about a patient's care. | | | | |
| | | | Be prepared. If your trip to the hospital is |
| Advantages of Hospitalists | | | | pre-planned, talk to your primary doctor |
| | | | about the hospitalists in your chosen |
| The hospitalist usually knows the hospital, | | | | hospital. Find out which hospitalist |
| and hospital politics, very well. This often | | | | communicates best with your doctor, and who |
| enables the hospitalist to cut through red | | | | your doctor prefers to work with. If |
| tape and "make things happen" more | | | | possible, ask your doctor to pre-arrange that |
| efficiently than office-based physicians. | | | | this hospitalist will be in charge of your |
| | | | care while you're in the hospital. |
| Hospitalists are more readily available to | | | | |
| respond to emergencies in the hospital. | | | | Arrive Armed: Never assume that things will |
| Nurses and other care staff can usually reach | | | | go as planned. You may not feel well, and you |
| a hospitalist more rapidly than an | | | | will be under stress. The chosen hospitalist |
| office-based physician, especially on | | | | may be on vacation, out ill, or unavailable. |
| evenings and weekends. | | | | Take a synopsis of your medical history, |
| | | | including the results of all recent tests, |
| Continuity of care within the hospital is | | | | with you to the hospital. Whenever possible |
| often better. When primary care physicians | | | | have someone stay with you in the hospital |
| manage inpatient hospital care, the patient | | | | until you have met your doctor and given him |
| is often actually seen by more doctors, as | | | | or her all the information you have. Have |
| doctors in larger practices often take turns | | | | that person take notes, including the names |
| seeing all of the practice's hospitalized | | | | of all your hospital caregivers, their |
| patients. | | | | contact information (phone and pager), and |
| | | | the location of their offices in the |
| Hospitalists are usually more accessible to | | | | hospital. |
| family members. Families don't have to try to | | | | |
| "catch" the doctor in the wee hours of the | | | | Sign a Release: If you can, make sure to sign |
| morning or late in the evening when he or she | | | | a release of information form when you are |
| is making hospital rounds outside of office | | | | admitted. This will give the hospitalist and |
| hours. | | | | everyone else on your medical team permission |
| | | | to discuss your care with the person you |
| Disadvantages of Using a Hospitalist | | | | appoint. Even if you have already given that |
| | | | person your Power of Attorney for Health |
| The biggest disadvantage to the movement | | | | Care, signing a permission to release |
| toward hospitalists is the loss of continuity | | | | information is a good idea. You might not be |
| of care between the primary physician and the | | | | so ill that your Power of Attorney for Health |
| hospital. The hospitalist has no previous | | | | Care goes into effect. In that case, without |
| knowledge of his new patient. If | | | | authority to release information, you might |
| communication between the primary care | | | | find the staff is less than willing to share |
| physician and the hospitalist is poor, it | | | | information with the person staying with you. |
| falls to the patient and the family to fill | | | | |