Our service views itself as practice partners with the primary care physicians we provide service to and feel that we are part of their group, not just hospital consultants. “I don’t feel like a hospitalist at all but [instead like] an internist following his own patients through hospitalization,” says Larry Holder, MD, FACP, who was in a solo internal medicine practice before joining the Hospitalist Services. “The schedule gives me the chance to bond with my patients and give them the optimal care that they deserve. Patients and their families frequently ask anxiously if I’m going to be there tomorrow or if there are emergencies [will I] be around. And to be able to say, ‘I’ll be here if you need me,’ gives patients and their families a sense of reassurance and instant bonding with the physician. At the end of the day, our profession is about healing the patient in a compassionate manner and not just about length of stay and cost reductions.”
Using a hospitalist model with multiple disruptions in continuity of care is analogous to having a Formula One race car but only being able to drive in rush hour traffic. The true potential of a hospitalist is constantly hindered when there is disruption in continuity of care. We should not be asking ourselves how to reduce the negative consequences of the sign-off process but, rather, how we can eliminate the process altogether. TH
Dr. Yu is medical director, Hospitalist Services, Decatur (Ill.) Memorial Hospital.
- Bell CM, Redelmeier DA. Mortality among patients admitted to hospitals on weekends as compared with weekdays. N Engl J Med. 2001 Aug 30;345(9):663-668. Erratum in: N Engl J Med 2001 Nov 22;345(21):1580.