Hospitalists reduce waiting time, improve care

Imagine being admitted to a hospital, lying in a strange bed in a strange room, waiting for a return call from your recently paged doctor. You are assured that the reply will come shortly, but every minute seems like an hour. Anxiety mounts as the nurses try to assuage your concerns.

Or, imagine sitting in your physician’s office reading outdated magazines waiting your turn, only to be told that the doctor has been held up at the hospital with an emergency. The soft-spoken receptionist behind the glass says she really can’t speculate on when the doctor will be back.

Neither scenario is in the best interest of patient or clinician, so in 1996 the National Association of Inpatient Physicians developed a new breed of doctor – the hospitalist, also know as inpatient care physicians.

These doctors work only in hospitals, with no outside offices or patients. Some primary care physicians choose to use this service for their patients’ hospital care, while others do not. Check with your own doctor for more information.

“Hospitalists reduce waiting time and improve care. We also save money,” said Dr. Scott Rusk, director of Eastern Maine Inpatient Care at Eastern Maine Medical Center in Bangor. Nationally, hospitalists have reduced hospital costs and length of stay by approximately 15 percent, he added.

It works like this: A person, let’s call him John, is admitted to the hospital and assigned immediately to one of the hospitalists on staff. John’s primary care physician is notified, and the two doctors are in contact during his stay. Upon discharge, John is back under the care of his regular doctor.

“One concern we hear is ‘They don’t know me. How will they know what I need?’ But we do know because we communicate with their primary care doc. We send e-mails, faxes, talk on the phone and use voicemail,” Rusk said. And hospitalists are specially trained in the kinds of medical issues that land people in the hospital in the first place, he added.

“It is impossible for a primary care physician to keep up on all the procedures, tests, drugs and innovations that we know about, just as we can’t keep up on all the drugs for preventing osteoporosis and controlling diabetes,” Rusk said. “One doctor can’t know everything. Working together assures the patient of getting the best care.”

Because hospitalists are always in the hospital, they are readily accessible to their patients, patient’s families and the nurses. Test results are seen quickly and, if necessary, medication can be adjusted immediately. The doctors can visit critically ill patients several times a day. And at EMMC they have a special pager just for inpatient emergencies.

“This is the Blue Meanie,” said Rusk with a laugh, holding up the bright blue pager named after a character in the Beatles’ movie “Yellow Submarine.” “It is with me at all times when I am on duty.”

For patient convenience, EMMC hospitalists work the same 12-hour shift seven days in a row. At each shift’s end, the doctors review the patient list, update conditions and make each other aware of anything that needs special attention.

“We take care of the sickest of the sick all the time,” Rusk said. “It’s what we do. We are on site, very connected to the hospital system and pharmacists.” The hospitalist model benefits everyone, he added. In-patients receive immediate care when needed, outpatients no longer have to wait for their doctors to complete hospital rounds before starting office hours, and doctors are not getting paged at all hours of the day and night – thus alleviating possible burnout.

“I think the hospitalist program has saved some marriages,” Rusk said with a laugh.

In Bangor, St. Joseph Hospital also has a hospitalist program.

Carol Higgins is communications director at Eastern Agency on Aging. For information on EAA, call 941-2865 or log on www.eaaa.org.