Seeing the good side
Having a hospitalist could mean a shorter hospital stay. According to the largest hospitalist study to date, hospital stays are shorter when managed by a hospitalist, in comparison with hospital stays managed by a general internist or family physician. Hospitalists are uniquely skilled at taking care of people in the hospital—from admission to discharge.
“Hospitalists can often get you in and out of the hospital faster because it’s a more efficient system. A hospitalist doesn’t have to leave for several hours to go see their private practice. They are right there, and things can happen much faster,” says Jonathan M. Flacker, M.D., Divisions of Geriatrics and Gerontology at the Emory University School of Medicine.
Most people know what it’s like to play the waiting game in a hospital. Questions have to wait until a doctor returns or has time to see you. In contrast, hospitalists, who are always on-site, are able to visit patients more frequently.
Additionally, “You have a doctor who knows the ins and outs of how the hospital operates,” says Flacker. They are familiar with the array of people and processes at work inside a hospital. “Hospitalists have a very close working relationship with everyone from the nurses to the administrators,” says Flacker. They may also facilitate connections with after care providers, such as home-health, skilled nursing, and specialized rehabilitation.
Dealing with downsides
Experts agree there is a major downside to having a hospitalist—you usually don’t know the hospitalist, and the hospitalist doesn’t know you. Unlike a PCP, you can’t shop around to pick the hospitalist you are most comfortable seeing. You receive care from the hospitalist who happens to be on duty.
“It’s hard to adapt to. It’s a change from seeing your PCP at the hospital, and that may feel different to you,” says Holden. “There’s an emotional tug-of-war for you between the connection and ties with a PCP versus the efficiency and practicality with a hospitalist.”
Also, the hospitalist may or may not have access to your medical record. “The transfer of information between the hospitalist and your PCP may be less than perfect, so I strongly encourage patients to be their own advocates,” Brotman says.
What you can do
Prepare a contact list of all your health care providers. Be sure the hospitalist teams up with the people who know the most about your health. Because the health needs of older adults can be complex, the hospitalist should talk to your PCP.
Also prepare a list of all your medications and allergies. Take the lists with you to the hospital, and if friends or family members accompany you, make sure they have this information too.
At Erickson communities, an electronic medical records system called Centricity contains medical histories, allergies, medications, and family contacts all in one place. Erickson Health doctors can easily print medical records so patients can take them to the hospital.
According to Brotman, “The lack of continuity with a hospitalist is dwarfed by the benefit of having someone who is comfortable practicing in a hospital in 2008.” But if it’s important to have your own doctor visit you when you are in the hospital, Brotman recommends, “Ask your PCP, ‘Do you see your patients when they go to the hospital? If not, who does?’”