Several weeks ago, I asked, "How do we feel about hospitalists?" I expressed my rather enthusiastic support for these hospital-based internists, as I have worked with many of them and found them to be attentive, patient- and family-centered, and highly focused on process improvement. Some people who commented felt differently.
But here comes a new study, entitled "Patient satisfaction with hospital care provided by hospitalists and primary care physicians," by Adrianne Seller and others. Here's the abstract.
Medical Staff Leader Connection summarizes:
Patients who received inpatient care from hospitalists were just as satisfied as those who received inpatient care from primary care physicians (PCP), according to a study in the Journal of Hospital Medicine. Patients who responded to the survey (2003-2009) were asked about physician care quality, physician behavior, pain management, and communication.
In multivariable models, hospitalists and PCPs scored similarly in the highest satisfaction category, 79.2% ranked hospitalists in this category, 80.5%, of patients put PCPs in it. There was equality in the improvement in quality ratings for both groups over the six-year period of the survey.
If 4 out of 5 patients rank their PCP and hospitalists in the highest category, then is there actually a problem with the patient experience at all? Certainly there are problems.
ReplyDeleteIn my experience, most hospitalists are fully engaged, interested, and qualified.
Issues arise due to the size of patient panels, the number of hand-offs from one hospitalist to the next, the discoordination among multiple specialty consultations, and lapses that occur at and following discharge.
It's not that people don't care. Caring matters, but by itself it is hardly enough. It has nothing to to do with lack of qualifications.
It's more the difficulty of letting everything mesh, in providing coherence.