From http://lubbockonline.com/stories/010909/loc_375424188.shtml
By Kristen Hackney-redman | AVALANCHE-JOURNAL
Friday, January 09, 2009
Story last updated at 1/9/2009 - 1:27 am
Doctors are busy people. If you've had to sit in a doctor's waiting room lately, that's certainly not news to you. But a relatively new and growing trend in medicine is helping doctors take better care of you sooner.
Hospitalists are doctors - typically internists - who work only in hospitals. The concept of hospital medicine developed in the late 1990s because physicians were having to run back and forth between hospitals and their practices, said Kaiser Tarafdar, a Covenant Medical Group physician who practices internal and hospital medicine.
Because they do not have clinics, hospitalists can focus their time and energy on caring for the very sick patients in the hospital, said Tarafdar.
Similarly, the primary care physician of a hospitalized patient would not have to travel between his or her office and the hospital to see that patient. That gives the physician more time to devote to the patients in his or her clinic - and ideally, less time in the waiting room for you.
But hospital medicine is more than just a time-saver for physicians and patients. It's also a life-saver.
The patients hospitalists see are typically much sicker than the patients seen in a doctor's office, Tarafdar said. Often the patients have multiple
health problems, he said, but hospital medicine is designed with certain protocols to improve the quality of care for these very sick patients.
For example, if a patient has an infection that has invaded the bloodstream, causing low blood pressure, and is not improving with fluids and antibiotics, the hospitalist would look for internal causes, such as the patient's adrenal gland function.
If the hospitalist found an adrenal insufficiency, he would treat the patient for that, Tarafdar said. Failure to identify and treat the adrenal insufficiency could lead to death, but such protocols, or standards of care, he said, are like reflexes to the hospitalist and have been shown to improve mortality and morbidity rates.
"You can make a real life-saving impact," said Tarafdar. "We are geared toward saving patients' lives."
Arundhati Harati, who is also an internist and hospitalist at Covenant, said as a hospitalist, she is more accessible to the hospitalized patient.
"I can be by the patient's bedside two, three or four times (a day) if need be," she said.
Harati also said working in the hospital allows her the chance to sit down face to face with the families of her patients and counsel them about their loved ones' situation. That way she can help them understand if they are making the right decisions concerning their loved one's care.
More and more patients are beginning to understand the role of the hospitalist, but Tarafdar said he does occasionally encounter a patient who is unfamiliar with the system.
"We always introduce ourselves to the patients," he said.
Harati agreed. She said the first thing she does is explain to her patient that instead of seeing his or her primary care physician, the patient will see her while he or she is in the hospital.
But while patients are under the hospitalist's care, the patient's medical records are accessible to the hospitalist physician, who also maintains regular contact with the patient's primary care doctor.
A hospitalist's job is to get his or her patient better faster and back into the community sooner, Tarafdar said.The hospitalist is able to do this because of his or her experience in caring for very ill people and doesn't have to divide his or her time between the hospital and a clinic.
Reducing the number of days a patient must stay in the hospital is better for the patient because she or he is happier at home, Harati said. But it is also cost-saving for the hospitals, insurance companies and patient, Tarafdar said.
Ultimately, the hospitalist's goal is to see a once very ill patient get better.
"When we take care of the sick patient and the patient walks out of the hospital, that makes me very happy," Harati said. "That would be the reason for me to get up in the middle of the night. ... I think that is why all of us are in the health care profession.
"I'm very proud to be a hospitalist."
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