Here's a sign in the Jacksonville, FL, airport. I've always had the highest regard for hospitalists, as I believe they make a substantial difference in the quality of care offered in hospitals. But I never realized that they had risen in stature to being viewed as a competitive differentiator in the obstetrics world, in which women often comparison shop before deciding where to give birth.
The several hospitalists-internists I have met this year at St. David's Austin are the absolute pits. You can't get away from them by going to say, Seton, because they are contract employees furnished by two companies here in town.
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ReplyDeleteIt is an absolute differentiator! As a woman and MD, I have chosen to deliver at a hospital with OB Hospitalist twice because a doctor who is already there will make vastly different decisions than one who is at home ( or at the golf course) who has to be interrupted to rush to the hospital. In the event of an emergency ( prolapsed cord, hemorrhage etc.) , I want the guy who is down the hall seconds away, Not the guy (or gal) who has to get into the car. Also the reverse, let's say that the doctor gets called in and labor stalls, who will be more tempted to perform an unnecessary c-section? Most likely not the one who is paid to already be there. A smart hospital will capitalize by educating their patients on the advantage.
Ray
ReplyDeleteSorry about your experience, but as you know, your opinion stems from a limited sample size.
I am an SHM lifer and began as a hospitalist before the word existed. Hospitalists have become the chief engineers of recrafting the hospital with the goal of making them safer and more effective. Too bad you didnt see the other side.
Browse our quality page and see what our society engages in--and I assure you these efforts are not in name only. We have driven improvements across the country, invisible ones, you might never see:
http://www.hospitalmedicine.org/AM/Template.cfm?Section=Quality_Improvement
Hope this helps,
Brad
Hospitalists entered midway through my career, and as a pathologist I am not really qualified to comment - but as a patient and family member, I am perturbed by the fact that hospitalists don't know the patient from Adam - and sometimes make no effort to carefully review the available clinical information and take a careful medical history. Of course, neither do non-hospitalists nowadays, but the consequences are different for an inpatient. I would think this would be pretty important in OB, too.
ReplyDeletenonlocal MD
Anonymous pathologist: Listening for ten minutes without interrupting is now one of my criteria for the contract hospitalists after watching several in action this year at St. David's in Austin, Texas. You are dead on (no pun intended) about not reviewing my wife's file before entering her room. Not a single one took a good history, either.
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