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Oncology, Surgical Hospitalists Most Common as Subspecialties Gain Followers


 

The recent rise of specialty hospitalists, particularly in the surgery and oncology fields, has benefitted hospitals and patients alike. Consider the growing ranks of oncology hospitalists, a small but quickly expanding HM specialty that has applied hospitalist principles to inpatient cancer and end-of-life care.

One such program at M.D. Anderson Cancer Center in Houston has attracted nine hospital-based physicians, four advanced-practice nurses, and two pharmacists since its launch in 2006. More doctors and nurse practitioners are being recruited, and the group is piloting an observation unit geared toward symptom management for an average of five oncology patients per day.

Although most inpatients cared for M.D. Anderson hospitalists are being treated for cancer, many have general medical needs, such as managing diabetes or high blood pressure, explains hospitalist Maria-Claudia Campagna, MD, FHM, assistant professor in the division of internal medicine at MD Anderson. Other patients, including those who don't yet have a confirmed cancer diagnosis, and family members of cancer patients may also be seen by the hospitalists. MD Anderson also has an established palliative-care service.

Increasingly, hospitals have employed specialty hospitalist teams, staffed by general oncologists or internal medicine hospitalists skilled at complex cancer care to care for inpatients with cancer, and the trend shows no signs of slowing.

Likewise, the practice of employing surgical hospitalists in non-trauma centers is gaining steam. Some non-trauma hospitals have reported improved patient outcomes and greater efficiency with surgical hospitalists.

A retrospective review of emergency surgical operations performed over five years at Sutter Medical Center, in Sacramento, Calif., found that an acute-care surgery model resulted in fewer overall complications, shorter lengths of stay, and lower hospital costs.

This approach by Surgical Affiliates Management Group, Inc. of Sacramento—the group contracted to perform the surgeries at SMC—combines elements of trauma, critical care, emergency surgical medicine, and elective general surgery, and it could be applied to emergency general surgeries at other hospitals that lack a trauma service without jeopardizing quality of care, the authors state.

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