- What if as a day care worker, you worked 7 days on – 12 hour shifts, then disappeared for 7 days.
- What if you had 60 new children to care for each day, and had no time to get to know them before you had to provide care?
- What if their needs changed daily, and you had only 10 minutes at the beginning of shift to get the highlights of those needs?
- What if you didn’t write anything down in those 10 minutes?
- What if all the children required different lunches, activities, and specified care – and you had to look in the computer to see what they needed, while you were also providing the care?
- What if you ordered tests for the kids, but were too busy some days to read the results of the tests?
I once heard a hospitalist explain his role in the hospital like a Quarter Back – calling plays, controlling the care etc. I like that idea and think it is a rather romantic view of hospital medicine. It is often, in its application much more complicated and not (in my personal opinion) always designed to put patient care first.
- Hospitalists are usually internal medicine trained, which is good, but often have less training than more specialized providers (for example – an MD has more training than a DO, who has more training than a NP, who has more training than a PA).
- Hospitalists are not always employees of the hospital which means they may not be trained in hospital policies, procedures, rules, etc.
- Hospitalists spend more time on the patient chart, than they do with the actual patient
- Hospitalists order tests – but don’t always take the time to review the results
- Hospitalists don’t know their patient histories – and may not have access to past medical records, admissions, conditions, medications, etc.
- Families have no idea who the hospitalists are – and therefore don’t communicate directly about concerns etc.
While there are many good hospitalists, we only see the worst case scenarios. We see where labs are ignored, patients sent home to suffer great harm, tests are not ordered and conditions worsen without care.
Be an advocate and work with your hospitalist to seek better care. Get to know her, ask questions.