Changing the course of hospital care
The unthinkable has happened. You were out mowing the lawn, blacked out, and woke up groggy and disoriented in an ambulance. You're rushed to the hospital's emergency room and asked if you have a family physician. You don't. Your condition is critical and requires immediate admission to the hospital. If you've been sent to Southern Maine Medical Center in Biddeford or Maine Medical Center in Portland, it's possible your care will be managed by one of a growing number of specialists whose area of expertise is changing the course of hospital care in the United States.
Meet your first hospitalist, a doctor specializing in hospital care. If you haven't heard of the specialty before, you're not alone. But that will likely change. There were only about 50 hospitalists practicing in the United States in the 1980s and that number grew slowly to a few hundred a decade ago. Now, there are about 5,000 hospitalists caring for about nine percent of the 33 million patients admitted to hospitals each year.
Although hospital care in Europe and Canada has long been provided by specialists in inpatient medicine, it was only recently that physicians and hospitals in the United States have discovered the advantages of hospitalist care. According to Dr. Robert Wachter, MD, associate chairman of the University of California-San Francisco department of medicine, hospitalist programs are growing because it appears to be a "logical, efficient, and higher quality way of organizing hospital care." Dr. Wachter's research shows that hospitalists not only reduce the number of days patients spend in the hospital, in most cases they also reduce the cost of care.
Most hospitalists, who are usually trained as internists, direct inpatient care. Your primary care physician can refer you to a hospitalist or if you are brought to the emergency room, need to be admitted to the hospital, and have no family doctor, you may be assigned a hospitalist. It's also not unusual for a surgeon to ask a hospitalist to manage a patient's medical needs. If you need the care of a specialist like a cardiologist, urologist or surgeon, or if you require home care, your hospitalist oversees the care. Because their focus is on your inpatient care, they work as your medical advocate.
A hospitalist faces critical issues frequently-often on a daily basis. And it's just this sort of experience that helps ensure quality of care and lower costs. Because they are in the hospital, they are able to respond immediately to real-time clinical data and changes in a patient's medical condition throughout the day, which has proven to help ensure quality of care and cost savings.
SMMC's hospitalist program, which was established in 1997, was one of the state's first and is the only such program in York County. Demand for the service has grown so dramatically that the medical center, which started with one full-time Hospitalist, now employs seven. The growth of hospitalist programs are a response to the changing needs of patients and physicians. Office patients are asking for more time with their doctors. Physicians are increasingly finding it difficult to meet the demands of hospital care. Hospitalists fill the gap, providing the best of inhospital care while enabling physicians to see an increasing number of patients and meet the growing demands on their professional and personal time. "The hospitalist program makes a lot of sense for patients and physicians," says Ed McGeachey, president and CEO of SMMC. "Maine Medical Center has also set up a similar program in Portland. As our program gains more capacity it may also be attractive to primary care physicians serving patients from other areas in York County, giving these patients their choice of a primary care physician close to home and hospitalization at a leading hospital under the care of a SMMC hospitalist."