Hospitalists help reduce costs, guide patient care
One of the hottest topics tied to the health care reform bill is the emphasis placed on reducing avoidable hospital readmissions. Some industry statistics show one in five patients is unnecessarily readmitted into the hospital, costing the government and taxpayers billions.
Avoidable readmissions are often the result of discharged patients either not following — or not receiving — thorough instructions about medications, not caring for themselves or not scheduling the necessary follow-up visits with their primary care provider.
As part of reform, hospitals will be penalized for avoidable readmissions, medical mistakes and other operating inefficiencies. By minimizing preventable readmissions, though, hospitals can improve patient care and reduce costs.
I recently learned of a relatively new breed of doctors called hospitalists who are trained to improve hospital operations. They work to ensure the patient receives proper medication and dosage, and arrange follow-up appointments with a patient's primary care doctor prior to discharge. Because the hospital is their primary location, hospitalists can spend more time with patients than doctors going back and forth between their practices and hospitals.
Experts estimate the hospitalist profession has grown from fewer than 1,000 in the 1990s to about 30,000 today, and it's only going to increase. "This is the fastest-growing physician specialty in history," says Joseph Miller, senior vice president for the Society of Hospital Medicine. "They're becoming the catalyst for change within the modern American hospital."
U.S. Health and Human Services Secretary Kathleen Sebelius attributes that growth to the demand from consumers for better case management.
"Having a primary point of contact once a patient reaches the hospital — somebody who is not only making sure that the right thing is done at the right time, but that the care is actually coordinated, that the family members know what is going on — that's often a huge help for patients and family," Sebelius says.
The biggest knock on hospitalists is they can have less connection with patients who don't know them — unlike family doctors — and being a go-between can raise the risk of miscommunication.
Miller says emphasizing communication helps alleviate that concern, as well as reassurance from a family doctor that hospitalized patients are in capable hands. Just as a pulmonologist can help a patient with lung problems, he explains, hospitalists help patients get the most from hospital care.
"It's logical for them to get involved and fix how hospitals work," Miller says.
According to The Journal of the American Medical Association, hospitalists are helping reduce the length of hospital stays by 17 to 30 percent, and reducing costs by 13 to 20 percent.
"They're in the best position to recognize problems and champion improvement," says Dr. Brian Harte, chairman of the Cleveland Clinic department of hospital medicine.
We've added hospitalists as a new category on the List, so if you've had an experience with one, please submit a report. I'm looking forward to following this trend and learning if hospitalists can, in fact, help improve our health care experience.