Putting focus on inpatient care
STERLING – Ronald Burgess spent 3 days at CGH Medical Center, from early Sunday morning to late Tuesday afternoon.
He saw a surgeon and probably a nurse or two, but he saw only one doctor, who directed his inpatient care: Dr. Nancy Tran.
Tran is one of seven hospitalists at CGH. Hospitalists are doctors trained in internal medicine who care only for patients in the hospital, from their admission to their discharge.
CGH implemented its hospitalist program in January 2008; it started with three physicians and has added a doctor almost every year since to accommodate a growing number of hospitalized patients.
KSB Hospital in Dixon started such a program in October 2010. It has five hospitalists who see patients.
Hospitalists might seem like more doctors in the revolving door of health care professionals whom a patient sees between the clinic and the hospital, but hospitalists are doctors with an acute focus on immediate health problems.
Hospitalists are immediately available all day, every day to patients and their families. And because they do not have a regular practice, they often can spend more time with patients.
Both CGH and KSB have two hospitalists on duty during the day and one at night to ensure someone is available 24 hours a day, 7 days a week.
Hospitalists also provide consistent, streamlined care while patients are in the hospital. They oversee care from admission to discharge; they can order tests and follow up on them, adjust treatments as necessary, and prepare for after-hospital care. They also can immediately respond to changes in condition.
All the while, hospitalists are in regular – often daily – communication with primary care doctors, so patients seamlessly transition from the hospital back to primary care.
Burgess, 50, of Sterling, who has been hospitalized three times for gastrointestinal bleeding, appreciates the attention from one doctor in the hospital.
“The focus is right there on the patient,” he said.
Burgess also appreciates the cooperation between hospitalists and primary care doctors.
“It’s really a team approach,” he said. “You have two people working together for you.”
Hospital medicine is a relatively new phenomenon in American medicine. In fact, the term “hospitalist” was coined in a New England Journal of Medicine article in 1996.
More and more hospitals are turning to a hospitalist model of care.
Primary care doctors are giving up their care of patients in the hospital, Tran said. They want to be more available to their patients at their regular practices; they don’t want to interrupt regular office hours – or wait until after office hours – to see hospitalized patients, she said.
About 50 percent of primary care doctors still see their patients in the hospital, though.
Hospitalist programs provide those in the hospital with immediate, uninterrupted care and attention, said Dr. Tammy Homman, a hospitalist at KSB Hospital. They are dedicated to dealing with problems that bring people to the hospital and that might arise while they are in the hospital, she said, and they often can handle issues more efficiently.
“It’s a different focus,” she explained. “It’s the same medicine, but a different plan for how to get [patients] over that immediate bump in the road.”
The hospitalist model of care often reduces the time patients are in the hospital.
Both CGH and KSB anticipate their programs to grow as primary care doctors, who currently still see their patients in the hospital, retire; as new doctors, focused on inpatient care, graduate; and as patient loads increase.