Thoughts on Hospitalists

[Guest cheech10]

Hi everyone,

I was wondering if anyone has worked with any hospitalists or heard enough about them to share their opinions. From what I've been reading, it seems like a really interesting and growing field.

[Guest Ian Wong]

I briefly worked with some of them at Vancouver General Hospital, but don't know enough about them to give you more than a superficial view as to what they do. Most hospitalists are family doctors by training, and they can work in groups so that a hospitalist can still spend time outside the hospital in walk-in clinics, doing locums, palliative/hospice work, whatever.

 

At VGH, when I was on the Internal Medicine service, we would admit patients into the hospital who needed to stay in the hospital for acute management of medical problems (ie. CHF exacerbations, ARF, GI bleeds, etc.) Once they were stabilzed, if they were still too sick to be discharged home, but didn't need to be taking up a bed on the IM service, they would be transferred to a less acute area of the hospital (ie. less nursing intervention, less monitoring, etc) and their care would be taken on by a hospitalist.

 

Similarly, if a patient needed to be admitted to the hospital, but wasn't necessarily sick enough to need to go to the IM floor (but would have been unsafe to go home), then the hospitalists would admit them directly, and we wouldn't even see the patient (they'd be triaged to the hospitalist by the Emerg doc). They would then, after stabilizing the patient, try to figure out a way for that patient to return safely to his/her home, or find nursing home placement for that patient if going home wasn't a safe option. We had a lot of patients transferred to the hospitalists post-stroke after the patients were stable, but it was clear that they weren't improving rapidly/significantly in their neurologic abilities.

 

In general then, they take care of less-acutely ill patients who need hospital care, but don't need a full-on Internal Medicine team looking after them. I'm sure this varies between hospitals, and you can probably find any level of autonomy and work out there if you so desire.

 

Ian