While doing the reporting for tonight's “Bill of Health,” I was struck by the continued rapid evolution of healthcare delivery in the United States. The report focuses on “hospitalists” -- hospital-employed physicians who are specialists in not just delivering hospital-based healthcare, but who also understand the inner dynamics of hospital operations. Soon, you'll also be reading about other odd-sounding specialties. Have you ever heard of a “surgicalist?” A surgicalist is a hospital-employed surgeon. A "laborist" is a hospital-employed obstetrician.
Physicians in each of these specialties are facing similar managed-care and scheduling pressures. In fact, fewer young doctors are showing interest in pursuing general surgery or obstetrics in part because they are traditionally the specialties that cut the deepest into personal and family time.
So hospitals are stepping into the job marketplace and offering an alternative by hiring hospitalists, surgicalists, and laborists. These physicians all forego the potential financial benefits of owning and growing their own practices. In return, they also forego the hassles of dealing with stingy HMOs, seeing a parade of patients every day just to keep the lights turned on and the staff paid, and getting phone calls in the middle of the night about a patient who has had an emergency admittance to the hospital.
What’s your take on hospitalists and the other hospital-employed specialties I mentioned? Have you had experience with these types of physicians? Do you think they improve the delivery of healthcare?
Comments
I already sent a comment on this, before I knew there was a blog, so I'm pasting it here again:
Your spot on hospitalists was superficial and misleading because of what it left out. Perhaps use of one can shorten a hospital stay in some cases, but not for the routine ones. Anyway, who wants to SHORTEN a hospital stay? Hospitals kick you out long before you should go; everyone knows that. And as for lowering costs, that's a joke. I recently had one-day outpatient surgery and three--count 'em--three hospitalists visited me within 15 hours and did nothing as far as I knew. But their bills were astronomical, and of course on top of my regular doctors'. And I think each of them must have ordered my medications because when I got the bill recently, I was being charged for sometimes 8 times my normal number of pills for a given medicine. Not only that, my real doctor came anyway, so of course he got to bill for that, too. Plus my cardiologist, whom I hadn't even known knew I was there. Surely I didn't need three others.
As much as we need doctors, especially in rural areas, why are we wasting them in this useless position? There are only three dermatologists within a 50 mile radius of where I live (which has one of the highest rates of skin cancer), and one of them doesn't take Medicare. But the hospital is overflowing with hospitalists! I think it's the profession for the lazy. And everybody is making money out of it except the patient/taxpayer.
I was recently hospitalized for three days, and had 3 different hospitalists take care of me.
After explaining my condition once, I never had to do it again. I suspect good communication between hospitalists and nurses is to thank for that.
There are also advantages to this method, not the least of which is getting a second opinion.