DO - Ohio University College of Osteopathic Medicine

director of the hospital’s medical and surgical transition
intensive care units.
Maxwell says the challenge of helping the most seriously
ill patients recover drew him into critical care medicine.
“[Caring for the sickest of the sick] requires continual inpatient
monitoring and both clinical- and procedural-related skills
to positively impact this population,” he says. “But on a
patient-family aspect, it is so wonderful to educate, talk
with and support families through these processes in the
ICU. This is why I came into medicine in the first place.”
Communication Plays Key Role
Despite the many benefits that hospitalists can provide, some
industry critics argue that switching providers can be stressful
to hospitalized patients at a time when they need stress the
least. And others point out that passing patient information
back and forth between providers creates potential for
inadequate communication, which could ultimately have a
negative impact on patient care.
Torres has heard both arguments and more, but he believes
the field is here to stay. “A lot of patients are surprised at first
when I come in to see them,” he says. “But once I explain
to them...they begin to realize that their doctor can’t always
drop everything at his or her office to come to the hospital
every time a patient is admitted. He or she has patients in
the office, too.”
Handling communication with the patient’s primary care
physician does take planning, however. In some integrated
health-care organizations where the primary care physician
and the hospital are part of the same group, sophisticated
computer systems might be available to link information
from the inpatient to office setting. More often, though,
hospitalists rely on more rudimentary tools for passing
along patient updates.
Grandview Hospital in Dayton automatically sends copies
of all lab work conducted on inpatients to their primary
care physicians. Hospitalists also dictate a discharge summary
for each patient that describes the diagnosis, treatment and
any further follow-up needed, which is faxed to the patient’s
primary care provider upon discharge, Torres says. If he
believes a patient needs more follow-up attention, he then
calls the primary care physician personally.
As a former primary care physician herself, Thomas considers
this relationship especially important. “Before I came, I don’t
think they contacted physicians much at all,” she says. “I
was told, ‘They get the discharge summary; that should be
enough.’” This person had never been in private practice.
Having experienced what it’s like to be blindsided by a patient
or family, I designed some fax notifications.”
Because hospitalists at Blanchard Valley Regional Health
Center work 10 24-hour shifts a month, patients there often
Eric Schumacher, D.O. (‘00), stresses the importance of
communication between the hospitalist and a patient’s
primary-care physician.
see different doctors each day. That, too, sometimes
proves to be a challenge to seamless care. “In our
case, patients have a different physician every 24
hours,” says Thomas. “I try to inform them of that
issue. There are times when I may be working every
other day, so that helps some, but that is where I hear
the most concern.”
That’s also where primary care physicians can work
together with hospitalists to provide the best care for
patients. “Sometimes, physicians stop for social calls,
which helps both the patient and us,” Thomas says.
“Sometimes, they are in a better position to discuss
sensitive issues than we are.”
Still, ensuring smooth transitions between inpatient
care providers and primary care physicians, or even
between two inpatient care physicians, has bumps.
“Multiple docs and multiple nurses and multiple
administrations can equal disaster with change.”
As the number of hospitalist programs across the
United States grows, the challenges of ensuring
adequate communication will only increase. “There
are fewer primary care physicians seeing their patients
as inpatients than there used to be,” Schumacher says.
“We try to assure our patients that we will update
their PCP about their condition and management.”
photo provided by Eric Shumacher, D.O.
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