The organization and practices of modern hospitals reflect the promotion of specialization and subspecialization by academic medical centers. As a result, many hospitalized patients have been subjected to visits by a bewildering array of physicians and other health professionals. Patients often report that they are not sure who, if anyone, is responsible for coordinating and monitoring all of these consultations and services. Recently, physicians called hospitalists have been hired by hospitals or insurers to work full-time in hospitals as the physicians of record for all of the patients assigned to them. Since they are more familiar with hospital procedures and in attendance at the hospital all day, hospitalists have demonstrated that they can provide more attentive, efficient, and economical patient care than is generally provided by attending physicians who spend a few minutes with each patient each day. In fact, the British health care system makes a clear distinction between office-based physicians and hospital-based physicians. Patients in England expect to leave their usual physician behind when entering the hospital and to be treated by a hospital-based physician during their stay as an inpatient. Write a brief opinion about this significant change in hospital care, addressing such questions as its effect on long-standing physician/patient relationships, quality of care, and patient choice.
The practices and organization in modern hospitals echo the promotion of sub- specialization and specialization by theoretical medical centers. Consequently, majority of hospitalized patients are visited by a bewildering range of physicians as well as other professionals. Patients report of the uncertainty of those responsible for monitoring and coordinating their services and consultations. Physicians referred to as hospitalists have been employed recently by insurers and hospitals to work in hospitals full- time as record physicians to all patients under their care. Alpers (2001) argue that hospitalists have more knowledge with all day hospital in- attendance and procedures. Hence, they have showed that they can ensure more economical, efficient and attentive patient care, which is provided by attending physicians who allocate only a few minutes to each patent daily. The health care system in Britain clearly distinguishes between hospital- based and office- based physicians. England patients expect to leave the normal physician behind and be taken care of by a hospital- based physician as an inpatient.
Effect on long-standing patient/ physician relationship
Many hospitalists’ negative reaction is from the utmost care doctors who use them. The theoretical ideas of having a single doctor oversee all patients’ care aspects, both outpatient and inpatient, is neither desirable nor possible. This is partly because some patients have a truly coveted primary care physician relationship that is a long- term (Cleary & Edgman-Levitan, 1997). Presently, the society and work force are mobile. As a result, change physicians after moving to a new job or town, since changing health insurers dictates physician change.
Hospitalists’ emergence in inpatient medicine offers a chance to assess a novel provider type and how it relates to family physicians. Family physicians and hospitalists have the opportunity to conduct research in the future to study hospitalist’s influence on family physicians and develop workable relationships with the new practitioners.
Quality of care
Health care systems prioritize better patient safety and quality of care (Lurie et al., 1999). In order to attain maximum positive impacts in the complicated inpatient environment, it is essential that a qualified coordinator facilitates the activities surrounding patient care and educates others. Hospitalists are identified as inpatient experts who possess the basic qualifications to maximize efforts and integrate hospital systems to ensure quality care. This is achieved through chairing therapeutics and pharmaceuticals committees, monitoring medication distribution, directing performance/ quality improvement projects, overseeing CPOE (Computerized Physician Order Entry) and collaborating with case management and discharge planning (Hruby, Pantilat & Lo, 2001). Hospitalists possess the lens through which to comprehend systems used for patient care. They have the opportunity to examine the processes under which they work since they care for patients each single day. They have the ideal perspective for reforming ineffective systems.
The patient’s choice is a reflection of perceived satisfaction. It is the reaction of the health care recipient to their service experience. According to Wachter and Goldman (2002), majority of patients report few quality of care technical problems in hospitals. Moreover, they do not feel adequate to critic technical quality and hence assume technical competence.
Hospitalists spend most of their time with patients. This ensures that a close relationship is created with the patient which leads to confidence. Patients therefore, open to hospitalists in regard to the preferred method of treatment. Patients become active decision makers. Being treated with dignity and respect, as well as being involved in treatment decisions are patient satisfaction and choice issues that are patients’ paramount issues (Wachter, 1999).
Hospitalists are more conversant with all day hospital in- attendance and procedures. Therefore, they can ensure more economical, efficient and attentive patient care, which is provided generally by attending physicians who allocate only a few minutes to each patent daily. Hospitalists will impact positively on long- term patient/ physician relationship, and openness on patient preferred treatment choices.
Alpers, A. (2001). Key legal principles for hospitalists. Am J Med. 111 (6), 5–9.
Cleary, P.D., Edgman-Levitan, S. (1997). Health care quality: Incorporating consumer perspectives. JAMA, 278 (11), 1608- 1612.
Hruby, M., Pantilat, S.Z., &Lo, B. (2001). How do patients view the role of the primary care physician in inpatient care? Am J Med, 111 (3), 21–25.
Lurie, J.D., Miller, D.P., Lindenauer, P.K., et al. (1999). The potential size of the hospitalist workforce in the United States. Am J Med, 106 (2), 441–445.
Wachter, R.M. (1999). An introduction to the hospitalist model. Ann Intern Med, 130 (4), 338– 42.
Wachter, R.M., &Goldman, L. (2002). The hospitalist movement 5 years later. JAMA, 287 (4), 487–494.
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