DO - Ohio University College of Osteopathic Medicine

“I really enjoy taking care of acutely ill patients with complex
issues, and a career as a hospitalist fits this perfectly,” he says.
“While I occasionally fill in for my outpatient colleagues to
keep up my outpatient skills, I prefer the acuity of the
inpatient setting. The complexity of the patients I see keeps
me up to date on the medical literature,” he says, adding
that, “The variety of disease processes I manage certainly
makes each day different and filled with new challenges.”
Growth in Field Benefits All
According to those who work in the field, the job of hospitalist
also offers numerous other benefits to physicians, hospitals
and patients. For physicians, there are predictable schedules,
average- to above-average pay, and the opportunity to avoid
the hassles and expenses of starting and growing a private
practice. Hospitals gain experienced inpatient care providers
who can consult with other physicians and surgeons and
treat patients admitted to the institution without a primary
care provider. And for patients, the benefits of having physicians
who are monitoring their care on site 24 hours a day are
immeasurable, some say.
“Patients are usually very grateful to see an attending physician
who is familiar with their care, checking in on them at any
hour of the day or night,” Schumacher says. “Certainly,
providing 24-hour care with in-house physicians provides
patients and their families extra comfort in knowing someone
can be there at a moment’s notice if needed.”
Industry proponents say bringing on hospitalists–who are
available throughout their shifts to monitor patient progress
and to adjust treatment as needed–has improved the overall
quality of care hospital patients receive. And by the nature of
their work, hospitalists have more experience treating patients
in a hospital setting than most primary care providers. The
result, they contend, is better outcomes at lower costs. And
their arguments have some basis; studies reveal that employing
hospitalists yields a 10 percent to 25 percent decrease in the
length of hospital stay, with a resulting decrease in costs, which
benefits the patients, the hospitals and the insurance companies.
And some physicians, such as Thomas, like how the specialty
meshes with real life. There’s less paperwork and more time
with her family than when she was a primary care physician.
“I guess the best thing is that when I am home, I am home.
I have no beeper outside the hospital and do not get phone
calls,” Thomas says.
Who Are Hospitalists?
According to SHM, two-thirds of major teaching hospitals,
one-half of other teaching hospitals and one-quarter of
nonteaching hospitals offer hospitalist programs. In the
industry’s earliest days, hospitalist programs were more
prevalent on the East and West Coasts, but now, hospitals in
almost all major metro areas and a growing number of rural
communities have hospitalists on staff.
Wherever they’re located, hospitalists have similar goals:
helping patients recover as quickly as possible or providing
quality end-of-life care to those whose conditions do not
allow for recovery. Still, the exact job description varies by
institution. Most hospitalists are employed directly by hospitals
or medical groups that work under contract with hospitals.
Some hospitalists work exclusively with adults, while others
treat both adult and pediatric patients. Some work 10- to
12-hour shifts several days a month, while others work fewer,
24-hour shifts a month.
Wayne Carlsen, D.O., F.A.C.O.I., combines inpatient care
at O’Bleness Memorial Hospital in Athens with his academic
responsibilities at OU-COM. Carlsen, chair of the Department
of Geriatric Medicine/Gerontology and associate professor
of geriatrics, handles most of the hospital-based care for the
five-member Geriatric Medicine Department of University
Medical Associates. He spends about one-half of each day
caring for hospitalized patients, which works well around
his academic duties at OU-COM, he says. But even this
schedule has its disadvantages. “In a hospital setting, the
caseload varies greatly,” Carlsen says. “I might have to see
two patients in that time one day and 22 another.”
” Multiple docs and multiple
nurses and multiple
administrations can equal
disaster with change.”
–Robin Thomas, D.O.
Still, he says, the work arrangement has advantages, too,
for physicians and patients. Because he focuses primarily on
hospital care, fellow physicians in his group can concentrate
on other responsibilities. And because he works at the hospital
regularly, Carlsen has been able to develop good working
relationships with other health-care workers at O’Bleness.
“They recognize my routines and I recognize theirs,” he
says. The arrangement also provides patients with a continuity
of care, since he typically sees a patient throughout his or
her hospital stay.
Most general hospitalists, including Thomas, Torres and
Schumacher, are trained as internists. But other inpatient
care providers, like Don Maxwell, D.O., F.C.C.P. (‘96), who
is certified in critical care medicine, have undertaken further
training to provide more specialized care to hospitalized
patients. Maxwell, who is considered an intensivist rather
than a hospitalist, cares for the most critically ill patients at
Banner Desert Medical Center in Mesa, Ariz., as medical
10 www.oucom.ohio.edu