New study evaluates hospitalists and their work

Nowadays hospitalists make up quite a fast-growing category of physicians. Once started the practice turned out a success and is likely to grow.

Photo: New study evaluates hospitalists and their work

Hospitalists become experts in the conditions they treat, are more committed to improving hospital processes that result in efficiencies, and free primary care physicians from having to come into a hospital to make patient rounds.

The term "hospitalist" was first used by Dr. Robert Wachter in a 1996 New England Journal of Medicine article. Hospitalist activities may include patient care, teaching, research, and leadership related to hospital care. Hospital medicine, like emergency medicine, is a specialty organized around a site of care (the hospital), rather than an organ (like cardiology), a disease (like oncology), or a patient’s age (like pediatrics). However, unlike medical specialists in the emergency department or critical care units, most hospitalists help manage patients throughout the continuum of hospital care, often seeing patients in the ER, admitting them to inpatient wards, following them as necessary into the critical care unit, and organizing post-acute care.

While it was commonly believed that any residency program with a heavy inpatient component provided good hospitalist training, studies have found that general residency training is inadequate because common hospitalist problems like neurology, hospice and palliative care, consultative medicine, and quality assurance tend to be glossed over.

According to the new study led by researchers from Tufts University School of Medicine, hospitalists reduce the average hospital stay by 12% off the average four-day hospital stay, but only modestly lower treatment costs.

The study showed that thanks to this category of physicians hospitals can find a solution for the problem of accommodation, especially with overnight patients. But it also highlighted that all the savings compared with care by a general internist turn out to be quite modest, and no significant savings over care provided by a family doctor.

The only drawback of the study is that it didn't look at quality of care. May be one of the disadvantages of the model is that it introduces a handoff between doctors. The primary-care doctor is caring for you in your office; then they refer you to the hospitalist for hospital care, then at the conclusion, the hospital refers you back to primary care.

And the advantages are that a patient is looked after by a doctor who spends his entire day in the hospital and is able to make decisions in "real time," unlike a doctor who stops in for rounds.