Written by SMH Senior Communications Editor Kim Savage
More than a decade ago, with a looming shortage of primary-care physicians in southwest Florida, Sarasota Memorial Hospital (SMH) leaders knew they had to do something to ensure hospitalized patients continued to receive ongoing and immediate medical care for acute injuries and illnesses.
In 2004, SMH hired its first two hospitalists, highly trained, board-certified physicians whose sole mission was caring for patients in the hospital.
The inpatient care specialist was an emerging trend at the time, but one that has transformed the healthcare delivery system, said Dr. Jack Rodman, chief medical officer for Sarasota Memorial’s First Physicians Group.
“Hospitals have become extremely complex care settings, with rapidly evolving treatment protocols and technologies,” Dr. Rodman said. “Having a core group of physicians wholly dedicated to inpatient care ensures patients receive the highly specialized medical care they need during their hospitalization. And, equally important, the 24/7 hospital coverage allows community physicians to spend more time with patients at their practice
Today, hospitalists represent the fastest growing medical specialty. Sarasota Memorial now has more than 50 hospitalists. Most are internal medicine or family medicine physicians, but the health system also has contracted a growing number of sub-speciality hospitalists, including general, orthopedic and trauma surgeons, neurologists, psychiatrists and obstetricians. SMH also has a longstanding contract and affiliation with Johns Hopkins All Children’s Hospital, whose neonatologists and pediatric hospitalists care for premature and critically ill newborns in SMH’s intensive care nursery, as well as children in the Pediatric Unit.
Despite some initial reservations by community doctors, the hospitalist program is increasing both patient and physician satisfaction. The SMH hospitalist group now has strong physician-patient partnerships with more than 200 community doctors and specialists that have resulted in better health outcomes and decreased hospital readmission rates.
The role of a hospitalist is similar to that of an ER doctor, who cares for you in the ER, and then turns you back over to your primary doctor when you leave the ER. Likewise, a hospitalist only sees patients while they are in the hospital. After patients are discharged, their medical issues are managed by their primary care physician.
As inpatient care specialists, hospitalists work hand-in-hand with hospital nurses, case managers, therapists and each patient’s primary care provider. They also co-manage specialty care that might be needed, meet frequently with family members and coordinate services that patients might need after discharge.
Introducing their medical specialty to patients can be puzzling at first, said Internal Medicine specialists Dr. Faisal Keen and Dr. Jason Kurecki, who serve as co-medical directors for the hospitalist group at SMH.
“Most of them have never heard of a hospitalist before, so there is a little education required when we meet for the first time,” Dr. Keen said. “But once they understand the unique skills we bring to their care team, they usually feel better knowing we are just down the hall, literally steps away if they need us.
Because of their onsite presence at SMH, hospitalists play an important role in hospital-quality committees and team-based care initiatives, and are an integral part of Sarasota Memorial’s new Graduate Medical Education program, supervising and training newly graduated physicians completing their Internal Medicine residency.
In general, studies show that hospitalists improve patient safety, continuity of care and clinical outcomes. Their knowledge of best practices and hospital-based safety procedures and protocols can prevent delays in care and reduce length of stay. And because the patients they see every day are often older, weaker and dealing with acute medical issues and a complex list of chronic medical conditions, they are experts in managing multiple medical issues simultaneously and minimizing the risk of complications and readmissions.
“Having hospitalists onsite optimizes everyone’s skills,” said Dr. Rodman. “They serve as the captain of the ship for patients while they are in the hospital and act as a personal advocate for each patient and that patient’s primary care physician.