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A day in the life of a hospitalist - Summer 2015
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By Dr. Peter Alperin, Internal Medicine at San Francisco VA Medical Center, and VP of Connectivity at Doximity

Hospitalist physicians are charged with the care of some of our nation’s sickest and most vulnerable patients, many of whom have little or no known medical history. These are the physicians who treat patients suffering from acute episodes, all the while coordinating care with multiple on- and off-site doctors for several patients at a time. Hospitalists have no time to spare; therefore, they must use their time efficiently and effectively.

Hospitalist physicians are easily the fastest growing and most in-demand physician specialty. There are approximately 50,000 hospitalists in the U.S. today, but the need is growing. So what do hospitalists do on an average day and what challenges do they face?

A hospitalist’s day typically starts around 7 a.m. Upon arrival, the physician gets “sign out” from their physician colleague who was on duty the night before. The report, which includes a status update on all current patients as well as new admissions, is given both verbally and electronically – either through the EHR or an electronic workflow tool used by the hospital. The information obtained during this time helps the physician prioritize the order in which the patients should be seen, and by 7:30 a.m., he/she has the day’s initial marching orders.

Dr. Richard Harris, hospitalist at MetroSouth Medical Center in Chicago, stated, “I typically start with the sickest patients first – patients in the ICU and others whose conditions have deteriorated.” Then the remainder of the 8-12 hour shift is spent working his way through the roster of patients, writing new orders, admitting new patients, teeing up those well enough for discharge, and finally handing off patients to the night-shift. A significant part of a hospitalist’s day is spent coordinating care for a range of 15-20 patients, in this fashion.

Then there’s the issue of continuing their education and staying in the loop on the ever changing clinical information pertinent to patient care. On slower days, a hospitalist might be able to squeeze in a lecture or grand rounds, and perhaps make a quality assurance or guidelines committee meeting.

A big challenge for all physicians, not just hospitalists, are preventable medical errors which stand as the fifth leading cause of death in the U.S. These errors often occur from a lack of communication or miscommunication. Medicine is an information-based profession and having a network in place to communicate effectively is vital. Dr. Harris says, “It really all comes down to communication. The better relationships you build with specialists and everyone else involved, the better the patient care will be. At the end of the day it’s all about helping the patient, and their family, recover from a health event.”

Many physicians are starting to find new and innovative ways to work both efficiently and effectively. Taking a page from their teenagers’ playbook, physicians are looking to social networking technology similar to Facebook or Twitter. Social networks make it much easier to find the right person and disseminate information quickly. With the right security precautions in place, the technology has significant implications for healthcare professionals. “Medicine has always been a heavily ‘networked’ profession. Complex patients require a team of experts and the hospitalist is at the center of this coordination. New advances in the way we communicate have made this easier,” Dr. Harris said.

Social networks are also an excellent way for doctors to stay up-to-date on the latest clinical information. Given the number of papers and journals being published every day, it’s hard to find the signal among the noise. So, much like the news you might read on your Facebook feed, doctors are turning to their peers for the latest medical news. “Nowadays, if I can’t read it on my phone, I won’t read it. I don’t have an office and rarely have time to sit in front of a computer and cull through the latest clinical news,” said Dr. Harris.

Bottom line, hospitalists are some of the most important people in the healthcare industry, and their time is precious. With new tools like Doximity’s secure social network, the medical community is taking a page from current trends and looking to the network to prevent error, establish better physician-to-physician relations and improve patient care. Understanding how they work and the challenges they face is key to help facilitate future career conversations with them.

5 Things you didn’t know about hospitalists:

  1. Hospitalist medicine is the fastest growing specialty
  2. The term “hospitalist” was coined in 1996 by the New England Journal of Medicine
  3. The hospitalist model is expanding beyond general medicine to specialties such as neurology and OB/GYN
  4. There are now special hospitalist fellowships that physicians can go through after finishing IM residency
  5. It’s estimated that more than 75% of all U.S. hospitals will have hospital medicine groups by the end of 2015

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