Q&A: Hospitalists

(This article was first printed in the October 2003 issue of the Harvard Men's Health Watch. For more information or to order, please go to www.health.harvard.edu/mens.)

Q: When my wife was in the hospital with a kidney infection four years ago, her doctor came in to see her every day, but when I caught pneumonia this year, my doctor turned me over to a hospital doctor until I got home. I did get good care, but I missed seeing my regular M.D. What do you think of this way of doing things?

A: Medicine has come to rely increasingly on specialists, and one of the newest is the hospitalist, a physician who devotes all his or her time to patients who are sent to the hospital, then transfers the responsibility back to the primary care physician when the patient is discharged. It’s a new twist on a long-established rotation system that allows one member of a group practice to supervise all its hospitalized patients while his or her partners remain in the office.

Hospitalists have been on the scene since the 1990s. The specialty was created to bolster efficiency, reduce costs, and improve care. The idea is that a doctor based in the hospital can watch patients more closely, respond to situations more quickly, and use the hospital’s resources optimally. These are laudable goals, but researchers don’t know how well they are being met. Preliminary studies suggest that hospitalists may be able to reduce the length of hospitalization and lower medical costs without reducing the quality of care or harming the patient-physician relationship — but these possibilities need to be studied further.

Is hospitalist care right for you? It depends on two factors. The first is communication. To provide the continuity of care you deserve, the hospitalist will have to stay in close touch with your primary doctor, and you’ll have to communicate with both. The second is choice. At its best, the decision to use a hospitalist should be voluntary for you and your personal physician.

It sounds as though your wife did well with the standard system of hospital care and that you did well with the hospitalist approach. We’ll have to wait and see if they can coexist peacefully in our complex health care environment

Harvey B. Simon, M.D.
Editor, Harvard Men’s Health Watch

(This article was first printed in the October 2003 issue of the Harvard Men's Health Watch. For more information or to order, please go to www.health.harvard.edu/mens.)

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