What is a hospitalist?

There’s a good chance that next time you are admitted to a hospital, a “hospitalist” will visit you. Coined in 1996 in a New England Journal of Medicine article, a “hospitalist” is a doctor who manages a patient’s care from the time they enter the hospital until the time they are discharged home.

There are 28,000 full-time hospitalists in the United States who work in 2,800 hospitals. Most hospitalists care for adult patients, although there are pediatric, surgical, obstetrical and medical subspecialty hospitalists. Fifty-two percent of all hospitals have hospitalists, and it has become the largest non-primary care field in internal medicine.

Hospitalists have a broad knowledge of general and subspecialty medicine. Although hospitalists can manage many complex medical patients on their own, they will ask medical subspecialists (such as cardiologists, pulmologists and gastroenterologists) or surgeons to assist them when specialized medical or surgical care is needed.

A hospitalist’s duties include diagnosing and supervising treatment; coordinating with subspecialists; ordering ancillary services (physical, occupational, speech and respiratory therapy); and facilitating discharge to home or to a nursing home for further rehabilitation. After the patient is discharged from the hospital, he or she is sent back to his or her primary care physician. A full description of the patient’s stay in the hospital also is sent to the primary care physician.

What are the advantages of having a hospitalist? They are available in the hospital 24 hours a day, 7 days a week. If a patient’s condition worsens during the night, they can be seen immediately and changes can be made in their care. Because the hospitalist’s office is the hospital, patients seen earlier in the day, who are waiting on test results before being discharged, can be seen again after the test results are back and can be sent home. By their constant presence in the hospital, hospitalists are able to identify problems and propose solutions that help the hospital to improve quality and efficiency. Hospitalists provide uniform care no matter which doctor in the practice sees the patient. Their practice patterns are based on the latest medical science and quickly change in response to new recommendations for patient care.

Hospitalists provide a round-the-clock, in-house patient care, leaving more time for primary care physicians to spend taking care of their clinic patients. While a patient is in the hospital, the hopsitalist is the physician responsible for the patient’s care. However, the patient’s primary care physician can visit the patient anytime. We encourage the primary care physician to communicate to us anything that they think will help with the patient’s care.

Studies show that patients taken care of by a hospitalist have a reduced mortality rate and improved outcomes. It also has been proven that the patient’s length of stay is reduced by half a day without adversely affecting his or her outcome.

The Eagle Hospital Physicians joined Blount Memorial Hospital in January 2008. We currently take care of patients who are admitted to the hospital for medical problems, and we provide supportive care for patients admitted to other services, such as surgery. We also take care of patients that come through the emergency department, who do not have a doctor. While most of our patients are seen in the emergency department first, a primary care doctor can request that we admit a stable patient directly to the hospital and bypass the emergency department.

Dr. Brian Hughes is a hospitalist with Eagle Hospital Physicians at Blount Memorial Hospital, specializing in internal medicine. He is board-certified by the American Board of Internal Medicine.

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