Hospitalists

Many hospitals are are being forced to hire hospitalists.  And I want you to know this is market driven, not being forced by the government.  Hospitalists are doctors, usually Internists, who are hired by the hospital, and at least one is available, in house, at all times. They take care of all patients admitted to the hospital.

They do not replace surgeons, pediatricians, obstetricians, neurologists, pulmonologists, allergists, or other such specialties.  What they do is take care of the general needs of the patients admitted to the hospital. If a patient has a heart attack in the middle of the night, the doctor will be right there, as opposed to treating the patient over the phone.  I like the change.

I think hospitalists will be similar to ER doctors, where some will be good and others will not be good.  Some will respect RTs and others will not.  The advantage to the patient is obvious, as they will be available to care for any of their immediate needs.

According to studies, there are other advantages:

1. Decrease in the need to transfer patients
2. Increased use of acute care skills (because keeping more patients)
3. Increase use of BiPAP and Ventilators
4. Increased inpatients

The problem is they cost a lot of money. 

Thoughts?

The Hospitalist: Are they good or bad?

So we do not have hospitalists where I work.  Generally, we have one general practitioner and one internist on call every night and on weekends.  These doctors have to take care of all the patients during off hours.  Yet sometimes they complain due to being overwhelmed.  They get calls at all hours of the night, and it gets tiring.

I have heard many of these physicians recommend our hospital have a hospitalist, and I imagine that's coming soon in the future.

What is a hospitalist?  It's a doctor who is in house, and he takes care of the patients that are admitted.  They work in 12 hour shifts just like respiratory therapists and nurses, and ER doctors.  When you have a problem with a patient, that doctor is right there to help out.  It's nice because you don't have to worry about a doctor not being available when you need one.  

This past weekend we had a general practitioner rental doctor, and she decided to stay all night.  At first I thought this was going to be a good idea, but she kept ordering new breathing treatments all night.  She ordered breathing treatments even on patients who didn't need them.  She'd call me at 2 in the morning because she wanted to give a guy Xopenex instead of Albuterol, even though the guy just had an albuterol and was not short of breath.  And then she decided to give every one of her patients "now one time mucomyst treatment"  

By the end of the night I wanted to choke her.

So after dealing with this doctor all night, I've decided that I'm not sure I want a hospitalist.  One of the advantages of working nights is you don't have to deal with doctors and stupid doctor orders.  Well, this doctor sure put an end to that advantage.  

However, I think if you got a decent doctor to be a hospitalist, it would work.  Yet if it's this doctor, I don't think I'd be very happy with my job.