September 8th, 2010 at 1:58 pm
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Hospitalists in Elders’ Future

by Isabel Fawcett, SPHR

Suddenly, hospitalizations, already murky in some circumstances, have become a little murkier in the age of sweeping healthcare reform. A couple things have captured my attention. Actually, many things have captured my attention, but I’ll just share one–for now.

Hospitalists Come of Age

First, I saw the articles in the news. Then, I saw a local classified job advertising, followed by another.

“WANTED: Hospitalists…”

Some hospitals are increasingly seeking and/or hiring hospitalists to oversee in-patients’ healthcare. If you’re wondering what ever happened to your good, old primary care, family practice, or, internal medicine doctor who managed successfully for years to treat outpatients and make hospital rounds to visit their other patients who were hospitalized, that concept is so, well, passé. Enter the hospitalists. Sounds like a movie in the making, doesn’t it?

Hospitalists are the latest and greatest resurrected medical specialists. The hospitalists specialize in caring for patients who are hospitalized, including elderly patients, among other patient populations. In some instances, hospitalists may be assigned to patients with complex medical histories and/or health complications. Make that high-risk patients – like elders. I’m making an effort to get with the lexicon of New Age medical practice. Can you tell?

Hospitalists are generally internal medicine specialists – licensed physicians. The good news is that a single or lead physician-in-charge of medical inpatient medical care theoretically lends greater consistency to patient care. The ‘other’ news is that some elders, and, even boomers like me, have developed long-term trusting relationships with our regular doctors.
Getting used to sterile and clinical hospital environments can be confusing to frail elders. Being hospitalized means new routines, new (paid) caregivers, and, occasionally, the effects of sedatives in elderly patients. For some elders, it is further anxiety-producing to add a new physician to the mix.

Even though the patient’s primary care physician remains in the background and should receive a complete medical status and records update, the hospitalist and in-patient hierarchy is still confusing to some elders. As one of my Mom’s generational contemporaries said of her own situation earlier this year, “To tell you the truth, I don’t even know anymore. There are so many doctors involved, I don’t even know what is going on anymore.”

Hospitals have 24-hour, 7-day weekly hours of operation. Similar to nursing shift rotations, each hospital patient served by a hospitalist necessarily will be cared for by at least 2, if not 3, licensed physicians. When an individual is frail, afraid, sick, confused and sometimes depressed, seeing one’s regular doctor may be the miracle cure.

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