It's an emerging trend, and one that many patients find confusing and uncomfortable: their primary doctor doesn't visit them in the hospital any more and doesn't manage their hospital care.
Primary care doctors are increasingly turning the care of their hospitalized patients over to specialists called "hospitalists."
The hospitalist is a hospital-based doctor who does not see patients in an office-based practice. He or she manages the care of patients only while they are in the hospital, turning them back over to their regular physicians when they are discharged. During the time a patient is in the hospital the hospitalist is responsible for all decisions about a patient's care.
Advantages of Hospitalists
The hospitalist usually knows the hospital, and hospital politics, very well. This often enables the hospitalist to cut through red tape and "make things happen" more efficiently than office-based physicians.
Hospitalists are more readily available to respond to emergencies in the hospital. Nurses and other care staff can usually reach a hospitalist more rapidly than an office-based physician, especially on evenings and weekends.
Continuity of care within the hospital is often better. When primary care physicians manage inpatient hospital care, the patient is often actually seen by more doctors, as doctors in larger practices often take turns seeing all of the practice's hospitalized patients.
Hospitalists are usually more accessible to family members. Families don't have to try to "catch" the doctor in the wee hours of the morning or late in the evening when he or she is making hospital rounds outside of office hours.
Disadvantages of Using a Hospitalist
The biggest disadvantage to the movement toward hospitalists is the loss of continuity of care between the primary physician and the hospital. The hospitalist has no previous knowledge of his new patient. If communication between the primary care physician and the hospitalist is poor, it falls to the patient and the family to fill in the gaps.
When a patient is discharged from the hospital the hospitalist relinquishes care back to the PCP. If communication has not been good, the primary care physician often has little knowledge of what the patient experienced in the hospital. Records are frequently slow to follow the patient, so on the first follow-up visit the office-based doctor may have scant information.
Without adequate information the PCP frequently makes adjustments to treatment plans and medications that are counter to the treatment plans initiated in the hospital.
How To Work With A Hospitalist
Be prepared. If your trip to the hospital is pre-planned, talk to your primary doctor about the hospitalists in your chosen hospital. Find out which hospitalist communicates best with your doctor, and who your doctor prefers to work with. If possible, ask your doctor to pre-arrange that this hospitalist will be in charge of your care while you're in the hospital.
Arrive Armed: Never assume that things will go as planned. You may not feel well, and you will be under stress. The chosen hospitalist may be on vacation, out ill, or unavailable. Take a synopsis of your medical history, including the results of all recent tests, with you to the hospital. Whenever possible have someone stay with you in the hospital until you have met your doctor and given him or her all the information you have. Have that person take notes, including the names of all your hospital caregivers, their contact information (phone and pager), and the location of their offices in the hospital.
Sign a Release: If you can, make sure to sign a release of information form when you are admitted. This will give the hospitalist and everyone else on your medical team permission to discuss your care with the person you appoint. Even if you have already given that person your Power of Attorney for Health Care, signing a permission to release information is a good idea. You might not be so ill that your Power of Attorney for Health Care goes into effect. In that case, without authority to release information, you might find the staff is less than willing to share information with the person staying with you.
Top 8 Nutrition Myths You've Been Taught To Believe
Don't always believe what you hear- especially when it comes to your health. Here's some nutrition myths we were taught to follow, and according to the experts, we shouldn't have listened to.
Sugar Causes Diabetes
So far, a diet high in calories, being overweight, and an inactive lifestyle are the main risk factors for Type 2 diabetes.
All Fats are bad
The key is to replace bad fats (saturated fats and trans fats) with good fats (monounsaturated fats and polyunsaturated fats) in our diet.
Brown Sugar is better than White Sugar
Unless you eat a gigantic portion of brown sugar everyday - the mineral content difference between brown sugar and white sugar is absolutely insignificant.
Brown Eggs are more nutritious than White Eggs
Eggshell color can vary but it has nothing to do with the quality, flavor, nutritive value, cooking characteristics or shell thickness of an egg. The eggshell color only depends upon the breed of the hen.
Avoid seafood to lower blood cholesterol
Saturated fats usually found in meat products and packaged foods, and trans fatty acids, are the most important factors that raise blood cholesterol, not dietary cholesterol.
Avoid carbohydrate to lose weight
Many low-carb diets do not provide sufficient carbohydrates to your body for daily maintenance. It doesn't matter if you eat a high or low-carb diet, you will lose weight if you decrease your caloric intake to less than that is needed to maintain your weight.
Avoid nuts as they are fattening
In moderation, nuts can be a part of a healthy diet. In fact, nuts are high in monounsaturated and polyunsaturated fats (good fats) as well as plant sterols which have all been shown to lower LDL cholesterol.
Skipping meals can help lose weight
Often times, skipping a meal results in an increase in total caloric intake than if we just ate more frequently throughout the day. A better approach is to eat smaller frequent healthy meals and snacks to keep our blood sugar balanced.
So now you know the real truth and when these come up in conversation again, you can educate your friends and family.
Chester is a health nutrition consultant and is the owner of AstroNutrition - a provider of premium health nutrition and sports supplements. Check out our Health and Fitness Blog!
Hospitalists: Can You "Catch" One In The Hospital?
It's an emerging trend, and one that many patients find confusing and uncomfortable: their primary doctor doesn't visit them in the hospital any more and doesn't manage their hospital care.
Primary care doctors are increasingly turning the care of their hospitalized patients over to specialists called "hospitalists."
The hospitalist is a hospital-based doctor who does not see patients in an office-based practice. He or she manages the care of patients only while they are in the hospital, turning them back over to their regular physicians when they are discharged. During the time a patient is in the hospital the hospitalist is responsible for all decisions about a patient's care.
Advantages of Hospitalists
The hospitalist usually knows the hospital, and hospital politics, very well. This often enables the hospitalist to cut through red tape and "make things happen" more efficiently than office-based physicians.
Hospitalists are more readily available to respond to emergencies in the hospital. Nurses and other care staff can usually reach a hospitalist more rapidly than an office-based physician, especially on evenings and weekends.
Continuity of care within the hospital is often better. When primary care physicians manage inpatient hospital care, the patient is often actually seen by more doctors, as doctors in larger practices often take turns seeing all of the practice's hospitalized patients.
Hospitalists are usually more accessible to family members. Families don't have to try to "catch" the doctor in the wee hours of the morning or late in the evening when he or she is making hospital rounds outside of office hours.
Disadvantages of Using a Hospitalist
The biggest disadvantage to the movement toward hospitalists is the loss of continuity of care between the primary physician and the hospital. The hospitalist has no previous knowledge of his new patient. If communication between the primary care physician and the hospitalist is poor, it falls to the patient and the family to fill in the gaps.
When a patient is discharged from the hospital the hospitalist relinquishes care back to the PCP. If communication has not been good, the primary care physician often has little knowledge of what the patient experienced in the hospital. Records are frequently slow to follow the patient, so on the first follow-up visit the office-based doctor may have scant information.
Without adequate information the PCP frequently makes adjustments to treatment plans and medications that are counter to the treatment plans initiated in the hospital.
How To Work With A Hospitalist
Be prepared. If your trip to the hospital is pre-planned, talk to your primary doctor about the hospitalists in your chosen hospital. Find out which hospitalist communicates best with your doctor, and who your doctor prefers to work with. If possible, ask your doctor to pre-arrange that this hospitalist will be in charge of your care while you're in the hospital.
Arrive Armed: Never assume that things will go as planned. You may not feel well, and you will be under stress. The chosen hospitalist may be on vacation, out ill, or unavailable. Take a synopsis of your medical history, including the results of all recent tests, with you to the hospital. Whenever possible have someone stay with you in the hospital until you have met your doctor and given him or her all the information you have. Have that person take notes, including the names of all your hospital caregivers, their contact information (phone and pager), and the location of their offices in the hospital.
Sign a Release: If you can, make sure to sign a release of information form when you are admitted. This will give the hospitalist and everyone else on your medical team permission to discuss your care with the person you appoint. Even if you have already given that person your Power of Attorney for Health Care, signing a permission to release information is a good idea. You might not be so ill that your Power of Attorney for Health Care goes into effect. In that case, without authority to release information, you might find the staff is less than willing to share information with the person staying with you.
