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#57337 - 07/19/09 11:02 PM Hospitalists
Sleepless in Dekalb Offline
Member

Registered: 04/17/09
Posts: 18
Loc: Dekalb
So I am about to start my Junior year this fall as in my pre-med undergrad career. I just had a baby this past January and am planning on having more children down the line. Is anyone here a hospitalist or work with any? I was looking into this as my future professional goal once and was looking for some feedback from anyone who can help. Do you like it? How is it? Are you in a specialized field? Do you have a family too? Thanks for any and all help! I am so happy to have found this community smile
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#57338 - 07/20/09 08:33 AM Re: Hospitalists
Cabinbuilder Offline
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Registered: 09/12/04
Posts: 1093
Loc: Oregon
Hospitalist are either family practice or internal medicine. Not sure what you mean by specialized??? I think the plus side of being hosptialist is that you have no office, no staff, you dictate on the hospital line, the hospital owns the charts. You do your own billing though. Depending on your group you can determine how mahy days a month you want to work. I have friends who work all the time (7 days a week) and then will take 2-3 week vacations. I have other friends who are mom's who work a few shifts a month to keep up skills and of course there are many variations of working schedules. I personally don't like hospitalist since there is no continuity of care, it's a patch them up and get them discharged mentality. Very impersonable.
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#57339 - 07/25/09 08:46 AM Re: Hospitalists
efex101 Offline
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Registered: 06/09/02
Posts: 2284
Loc: MN
I have to disagree with the "patch them up and get them discharged" and it not being personable. Hospitalists provide a much needed element in medicine. Patients get acutely ill all the time and unless every PCP is willing to take frequent night call *and* see patients in clinic, it is here to stay. We do not just patch them and street them, many times we make changes to their medications, ensure they have adequate follow-up, set them up with a PCP if they do not have one, etc....
I am obviously planning on going into hospitalist medicine and I hope not all PCP think like you about us.

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#57340 - 07/25/09 12:23 PM Re: Hospitalists
HAM Offline
Elite Member

Registered: 03/04/05
Posts: 395
Loc: UT
In addition to what efex101 said, there is quite a big difference between the acuity and management in the hospital versus in the clinic. I think its best to have experts running the show in each venue.

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#57341 - 07/25/09 05:14 PM Re: Hospitalists
Cabinbuilder Offline
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Registered: 09/12/04
Posts: 1093
Loc: Oregon
I only said it that way because that's what I've seen here in residency. I wasn't trying to make light of what a hospitalist does, just my experience here. If that's not the case where you are, I'm glad. I was not fond of our hospitalist service here and many patients who really needed a PCP don't ever get one and realy on the ER/inpatient service for everything. We had to discharge people "for the essence of time" before I thought many were ready. Our boss is very money hungry and the more he admits, the better he gets paid.
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#57342 - 07/26/09 09:24 AM Re: Hospitalists
Sleepless in Dekalb Offline
Member

Registered: 04/17/09
Posts: 18
Loc: Dekalb
It is interesting to see both sides of this situation. Thank you everyone for your comments and experiences. I'd like to think that hospitalists can provide an important/valuable experience for the patients while making a positive difference. I have had some bad hospital visits via doctors that are too rushed or felt like they didn't care. I hope to be a source of healing, comfort, and help to those in times when it is crucial, even if it is not for long. PCPs seem to be pulled into so many different directions and I think hospitalists can be great partners to help lessen the load. Has anyone here seen more internal medicine hospitalists or is there equal demand for specialists?
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#57343 - 07/26/09 10:16 PM Re: Hospitalists
DocM Offline
Elite Member

Registered: 01/28/08
Posts: 155
Loc: US
Where I live in the Pacific Northwest, the vast majority of hospitalistsat my community hospital are internists who do strictly in patient medicine.

The hospitalist model is beginning to expand here to include other specialities - surgery and Ob ( as laborists). We also have a neurologist hospitalist to manage the acute strokes inparticular, and have a pediatric hospitalist to do mostly the newborn care and manage the small peds unit ( we do not have a PICU and only a small NICU). Pediatric critical care is pretty much a hospital only field too. The adult pulmonary critical care people here have pretty much divided themselves into those who do inpt medicine - manage all the ICU patients and see the inptpulmonary consults, and those who do outpt pulmonary/sleep lab stuff.

I haven't seen any other medical subspecialties divide up this way yet - no cardiac hospitalists,GI hospitalists, heme onc hospitalists. However, many practices in these specialities are increasingly having their patients managed by hospitalists while in pt ( unless electively admitted for say a procedure or for chemo), serving only to "consult" on them - meaning they don't get paged with everything - the hospitalist does. Some practices also schedule it so that one doc in the group, GI for instance, will do a whole week of inpatient work - all the consults, all the inpatient procedures - doing nothing outpt until the folllowing week.

In my opinion it is a useful model because medicine is getting so broad and complicated that outpatient work is often very different than inpt work. It also does provide a better lifestyle with more predictable hours for everyone involved and ideally better treatment for the patients. Ultimately the quality of care delivered depends however on good communication between the PCP, any involved specialists and the hospitalists - without that it can't work.

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#57344 - 08/15/09 05:12 PM Re: Hospitalists
kpzr/9145 Offline
Super Elite Member

Registered: 01/04/06
Posts: 665
Loc: massachusetts
Like everything else in medicine these days, this leads to less continuity of care.

My large pediatric practice has just started using a pediatric hospitalist service for our inpatients which is GREAT for me and I think better for the patients, in that they receive more up to date medical care. However, we still round on these patients in a social sense which takes every bit as long and sometimes even longer. I know the patients like it but it is totally unreimbursed time and frustrating for me, it often takes just as long to round as it used to. If it were up to me, I would only pay a social call to a personal patient of mine or in special circumstances.
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#57345 - 08/22/09 06:35 AM Re: Hospitalists
efex101 Offline
Super Elite Member

Registered: 06/09/02
Posts: 2284
Loc: MN
Where I work there are "no social" visits unless the doc happens to be at the hospital. Is this mandatory at your place? I mean that somewhat defeats the purpose of having a hospitalist service available. Sure, patients love it, but at some point the line has to be drawn. You could also call you patient while in the hospital, let them know you are aware/concerned and see them once they get discharged.

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#57346 - 08/25/09 02:41 PM Re: Hospitalists
LauraMD Offline
Member

Registered: 07/05/02
Posts: 67
Loc: NV
I love my hospitalist service! I think they do a great job.

I do 'social rounds' on pts with whom I have a good relationship (the pt who only saw me once 3 years ago is not as needing of this visit as the one I've seen every month for a year.)

If it weren't for my hospitalists, I would be much more stressed and hurried with my pts, both in-house and in clinic. For example, it is a nightmare when you are in the middle of a clinic day and you get a page from the hospital that the little old man you admitted with pneumonia is now having 10/10 abdominal pain. It's hard to drop everything and run to the hospital. Hospitalists do a specific job, and they are generally good at it.

I have friends who are hospitalists, and they tend to like the flexibility, though sometimes they work really hard on their shifts (heck, I do too!). It's all a matter of what suits your personality, I think.
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#57347 - 08/25/09 03:20 PM Re: Hospitalists
Doc201X Offline
Super Elite Member

Registered: 09/14/03
Posts: 2643
Loc: Hot a$$ Texas
Personally, I think it takes a special kinda Doc to want to be a Hospitalist in the same vein as I see people who become Nurses.
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#57348 - 08/25/09 04:13 PM Re: Hospitalists
Popcorn Offline
Super Elite Member

Registered: 04/27/04
Posts: 673
Loc: Florida
Not sure what you mean by that... it was quickly becoming the default option at the IM residency at the hospital where I trained (for those IM'ers who didn't land a fellowship.)

I'd argue that it's a special kind of doc who wants to run a practice and still admit all her own patients.

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#57349 - 08/25/09 06:46 PM Re: Hospitalists
Doc201X Offline
Super Elite Member

Registered: 09/14/03
Posts: 2643
Loc: Hot a$$ Texas
Quote:
Originally posted by Popcorn:
Not sure what you mean by that... it was quickly becoming the default option at the IM residency at the hospital where I trained (for those IM'ers who didn't land a fellowship.)
Sounds like the comments I use to hear about people who went into Pathology, ie they couldn't get into any other residency program. :rolleyes:
Quote:
Originally posted by Popcorn:
I'd argue that it's a special kind of doc who wants to run a practice and still admit all her own patients.
Yeah one of the term's I've heard was money hungry. :p

Honestly I think there are enough indirect (yours) and direct(mine) snide comments to make about Docs to around, don't you? confused

Like I said before, Nurses and Hospitalists, VERY special medical professionals IMHO.
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#57350 - 08/26/09 06:17 PM Re: Hospitalists
efex101 Offline
Super Elite Member

Registered: 06/09/02
Posts: 2284
Loc: MN
Thanks! as I am for sure considering hospitalist and NOT considering fellowship due to the healthcare debacle to come. I could not for sure do primary care (at least not at this point of my life) with the endless phone calls, pages, e-mails and issues with patients. I spend more time fielding calls on some patients than I would spend time on a new admission wink
Also, each career track has it's ups and downs but my personality is work hard then play hard (aka a la military). I love the flexibility of a hospitalist position and the plethora of different practice styles to choose from.

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#57351 - 08/26/09 07:58 PM Re: Hospitalists
Doc201X Offline
Super Elite Member

Registered: 09/14/03
Posts: 2643
Loc: Hot a$$ Texas
Quote:
Originally posted by efex101:
Thanks! as I am for sure considering hospitalist and NOT considering fellowship due to the healthcare debacle to come.
No Problem, you know I've always been one of your fans anyway, LOL!! And it's no suprise that this would appeal to you as a former Soldier!

But perhaps this is yet again, one of those things where perhaps a little experience with Hospitalists as a PATIENT as I have, is required to gain a full appreciation for this specialty.
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#57352 - 08/27/09 06:33 PM Re: Hospitalists
efex101 Offline
Super Elite Member

Registered: 06/09/02
Posts: 2284
Loc: MN
I agree, and not all hospitalist groups are the same either. It can sure be lucrative ($$$$) but at the expense of a lot IMHO. You can not manage 20-30 patients and do the best for the patient and keep your sanity. I prefer to make less but have the right amount of patients to do the best for their care, keep myself sane, and be happy doing an excellent job with good outcomes for the folks I will take care of.

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#82568 - 11/03/11 02:54 AM Re: Hospitalists [Re: LauraMD]
Nycs Offline
Member

Registered: 11/03/11
Posts: 1
I just had a baby this past January and am planning on having more children down the line.It's hard to drop everything and run to the hospital. Hospitalists do a specific job, and they are generally good at it.I mean that somewhat defeats the purpose of having a hospitalist service available. Sure, patients love it, but at some point the line has to be drawn.


Edited by Nycs (11/03/11 02:55 AM)

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#83718 - 01/31/12 01:29 AM Re: Hospitalists [Re: Nycs]
Johnsutan Offline
Member

Registered: 01/30/12
Posts: 5
Well there is no doubt that hospitalist service is very good but you have to take care about your child carefully . I also say that you need to join hospitalist group too .
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#83893 - 02/14/12 10:55 PM Re: Hospitalists [Re: Johnsutan]
clovermom Offline
Member

Registered: 09/03/10
Posts: 25
Loc: Southeast
Can you do part-time work as a hospitalist? If so, how is the schedule worked out?

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#83903 - 02/16/12 12:26 PM Re: Hospitalists [Re: clovermom]
efex101 Offline
Super Elite Member

Registered: 06/09/02
Posts: 2284
Loc: MN
Yes, there is part-time hospitalist usually (but lots of combinations depending on group) is one week/month or so. There are hospitalists that work M-F 8-5 no weekends or weekend call no night call, there are really many permutation but YOU may have to move/relocate.

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