Hospitalist Care Does Not Mean Better Care
Who is better suited to look after you during a hospital stay: your primary care doctor or a doctor who specializes in caring for patients in hospitals? You may be surprised to learn a recent study’s answer to that question.
Traditionally, your primary care doctor admitted you to the hospital and looked after you throughout your stay. However, over the past few decades, increasing cost pressures have made such an arrangement less common. More and more patients are admitted and cared for by hospitalists, internal medicine doctors who only practice in hospitals. The idea is that hospitalists can most efficiently coordinate care, thereby reducing the length of a patient’s hospital stay and keep costs down.
What is lost with the hospitalist approach, of course, is the personal knowledge your primary care doctor has about you. He or she not only has superior understanding of your health history, but also knows more about your emotional needs and likely has some relationship with your family members. These aspects of the physician-patient relationship can be crucial during life-threatening problems in the hospital, and could easily be underserved when a hospitalist manages your care.
For the first time, a recent study looked at whether care by a hospitalist actually leads to increased medical care cost savings, as claimed by insurance companies and others. The results were surprising. The study, which appears in the August 2, 2011 issue of The Annals of Internal Medicine, found that patients cared for by hospitalists were less likely to be discharged home rather than to a rehabilitation or nursing facility. It also found that patients cared for by hospitalists were more likely to have emergency department visits and readmissions after discharge.
The study concluded that any decreased length of stay and hospital costs associated with hospitalist care were offset by higher medical utilization and costs after discharge.
So what is the bottom line for patients? Whether you are being cared for by your primary care doctor or a hospitalist, it is important you advocate for yourself or your loved ones. Make sure your regular doctor communicates with the hospitalist and is aware of everything he or she should know with regard to your medical history and treatment. After you are discharged, make sure your doctor knows what went on during your hospital stay.