If you wind up in a hospital, you could receive the services of an obstetrician, an internist, a surgeon or an orthopedist. But unless you’ve paid a visit lately there’s a new one you haven’t met — the hospitalist. Doctor Gary Rosenthal practices at the VA Iowa City Health Care System and is a professor at the University of Iowa Medical School. He’s also a researcher who’s studied the benefits of having a doctor whose specialty is the patient’s overall care in a hospital. Hospitalists are a relatively new thing to medicine, and the term means a doc who spends most of their time caring for patients who are admitted to a hospital. Typically those patients are on internal medicine services. A hospitalist is often the doctor who talks directly with a patient’s HMO about their care, what’s needed…and what’s not. He admits the managed-care industry led to the creation of hospitalists, to manage care and decrease its costs. Dr. Rosenthal says with a hospitalist on the case, he found the average patient had a shorter stay, and a smaller bill. Patients on average stayed one day less in the hospital, and their bill was 10-11 percent lower. Perhaps most important, Rosenthal also studied rates of readmission and patient death, and confirmed that those discharged earlier were not suffering any ill consequences. It’s not for all patients, Rosenthal says, but those most likely to benefit from the supervision of a hospitalist may have conditions like pneumonia, heart failure or diabetes complications. And their doctor, the hospitalist, spends more time in the hospital than most M-Ds. They introduce “efficiencies of care,” being available readily if the patient has a problem, not away at an office. They also know the therapists and other professionals better and that makes for a better care team. Rosenthal says the per-day cost was actually higher for patients supervised by the hospitalist, but sending them home earlier helped save money overall, especially if they lived close enough to get continuing outpatient care.
