Hospitalists routinely have to handle infection cases, but how well trained are they to do so, and how well prepared are the hospitals they work in to support them on difficult cases?
It depends on training and the institution, but both areas have room for improvement, says a physician who has had feet on both sides of the fence.
Leland Allen, MD, says there is no easy answer on whether hospitalists have enough baseline training.
“What I see locally in Birmingham is that there is a wide variation in the training,” he says. “The hospitalists that I see that are family-practice-trained, just as the nature of the family practice training [goes], have a whole lot of outpatient experience. And so these people don’t have nearly the inpatient experience in their training that people trained in internal medicine do.”
—Leland Allen, MD, infectious-disease physician, Shelby Baptist Medical Center, Birmingham, Ala.
Some hospitalists, Dr. Allen says, are as proficient in dealing with inpatient ID cases as he is. Others are clueless, he says. “It really just depends on the training. It would be nice if there was some standardization of training, rather than just kind of catch-as-catch-can.”
As for ID resources available at hospitals, Dr. Allen says, “there is potential in any hospital to have an excellent backbone program of infection control.” But that depends on the availability of ID experts and the willingness of hospital administration to invest in the program.
“A well-developed, well-maintained infection-control program, with a good infection-control nurse, can really help a hospitalist to understand the types of infections that they’re up against in that particular institution,” Dr. Allen explains. “It really pays off down the road for the hospital with reduced infection rates, and also physicians who are practicing in the hospital, in terms of making their life a little bit easier.”
And with changes in Medicare reimbursement for hospital-acquired infections, he says, “it really behooves a hospital to spend some money up front.”