Monday Medical: The role of the hospitalist
For Steamboat Pilot & Today
If you’ve ever been hospitalized, chances are you’ve been seen by a hospitalist — a physician who cares for patients during their hospital stay. Dr. Gary Breen, a hospitalist for UCHealth Yampa Valley Medical Center, outlines the role of hospitalists below.
What do hospitalists do?
“We essentially spend all of our time in the hospital, taking care of patients who have been admitted,” Breen said. “We see patients who have come through the emergency room or who were admitted directly from a clinic, and we have a consultative role in helping take care of surgical, orthopedic and OB/GYN patients.”
Many hospitalists are trained in internal medicine, though a few come from a family medicine background.
When will I see a hospitalist?
If you’re staying overnight at a hospital, you’ll likely be under the care of a hospitalist.
“Most patients in the hospital are being seen by a hospitalist,” Breen said. “A large percentage of our patients come from the emergency department.”
For instance, if someone arrives at the emergency department with shortness of breath, the emergency medicine doctor will assess the patient and run appropriate diagnostic tests to figure out the medical issue. If that doctor feels the patient shouldn’t be discharged, a hospitalist will be called in. The hospitalist will assess the patient, talk with the emergency medicine doctor and review diagnostic tests to determine a treatment plan and then admit the patient to the hospital’s patient care unit.
The history of hospitalists
Hospitalists have been around since the 1990s. Before hospitalists, primary care physicians would care for their patients whenever those patients were admitted to the hospital.
“Those physicians would see the patient quickly in the morning, then head back to their clinics for office appointments and return to the hospital at night,” Breen said. “If something happened to the patient during the day, it could be challenging — the physician might have 20 people scheduled to see them but would have to run to the hospital to deal with a situation that may take an hour or two. The hospitalist’s role evolved because of limitations with that model.”
The very nature of a hospitalist’s job means that he or she is readily available, often seeing a patient more than once a day and helping to explain treatment plans and test results to patients and their families.
“That’s what makes us unique,” Breen said. “We’re physically here all the time to provide care for patients.”
Hospitalists also have a depth of experience managing acutely sick patients.
“We’re not managing chronic diseases, such as high blood pressure and diabetes,” Breen said. “We take care of people who are acutely ill — people who have acute respiratory failure, severe pneumonia, renal failure. The management is different.”
At the same time, hospitalists have to understand how to care for patients with a wide variety of issues.
“In some ways, we’re a jack-of-all-trades,” Breen said. “But we have to understand our limitations of what we can provide locally and recognize when a patient may need to be transferred to a higher level of care.”
And hospitalists are team players, working with other physicians at the hospital and in the community, communicating information about new diagnoses, follow-up appointments and discharge instructions to primary care physicians.
“We work very closely with other physicians, particularly with the surgeons,” Breen said. “We’re working side by side on a daily basis.”
Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at email@example.com.
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