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The Hospitalist: Care Management In House

By Michelle Seitzer / Posted on 20 July 2010

Although there hasn’t been much breaking news on health care lately, the reform wheels are in motion and change is coming.

A major component of health care reform is reigning in the cost of avoidable readmissions, which currently eats a hefty $17.4 billion slice of the $102.6 billion Medicare pie (and affects one in five patients). Thus, under the new legislation, hospitals will incur penalties for readmissions, medical errors, and inefficient operating systems.

Enter the hospitalist.

While the first hospitalists emerged in the early 9o’s, the presence of these physician-administrator specialists is on the rise. Medical experts are hopeful that these new health care professionals will act as agents of change, ushering in the transitions required by the Obama administration.

Charged with managing the care of hospitalized patients whose family doctors are unable to make hospital rounds, and in some cases, coordinating care for patients who have no family doctor, hospitalists oversee the entire patient care plan (entry, treatment, and discharge), thus “reducing the length of hospital stays by anywhere from 17 to 30 percent, and reducing costs by 13 to 20 percent,” as per recent studies cited in JAMA (Journal of the American Medical Association).  That’s certainly something to cheer about – how many people do you know that actually want to stay at/pay the hospital longer than they have to?

To read more about the functions of a hospitalist, check out this recent New York Times piece, highlighting the work of Dr. Subha Airan-Javia at the hospital of the University of Pennsylvania.

It’s an interesting concept which seems to hold merit in terms of cost containment and more competent care management. I’m not crazy about the name – it sounds so sterile and technical, or like the title of a movie where the protagonist is some kind of hospital monster – and it doesn’t quite seem to match the work that they do.

I have not had extensive experience with hospitals (other than being a visitor), and I was a patient only once, at the age of one.  As a visitor, I certainly observed inefficiencies, but I would imagine that a hospitalist would not have been the solution to every problem. Perhaps if a hospitalist acts as a patient advocate, specifically in cases where the patient has no family doctor or maybe even no surviving family members, I would support their work wholeheartedly. But if it’s just one more layer of bureaucracy, one more person to breeze in, speak medical jargon, ask how the patient is feeling, then breeze out, I’m not sure I’m a fan.

What are your thoughts?

-Michelle Seitzer

There is One Comment about this post

  1. Jane says,

    It’s unfortunate that a hospital is so big that a hospitalist is needed, but, I have to ask: What is best for patients?

    I’m reminded of when a manager comes around at a restaurant. It’s annoying, but it’s kind of nice to know they’re checking up to make sure you’re satisfied.

    I agree with you though. Perhaps if the hospitalist’s job was to add a personal touch and ask questions that doctors or nurses may not have time to ask, then it might not be as bad. And I don’t like the name either.

     

    on 21 July 2010 / 12:00 AM

     
 

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