Where Is My Doctor?

HYANNIS – A relatively new medical specialty is taking some patients by surprise when they are admitted to the hospital. Here’s the 411 on hospitalists, doctors who only treat inpatients.

The word first appeared in print in 1996—the same year ‘smartphone’ joined our vocabulary—according toMiriam-Webster, which didn’t add hospitalist to the dictionary until 2005.

Not all hospitals are fortunate enough to employ these doctors to provide around-the-clock inpatient care, but most people admitted toCape Cod Hospital(CCH) orFalmouth Hospital(FH) can expect to have a hospitalist take care of them. In some cases, your own physician may continue to care for you while you are in the hospital.

Cape Cod Hospital currently has 24 hospitalists and six advanced clinical practitioners (nurse practitioners and physician assistants), while Falmouth Hospital has 11 hospitalists and 12 advanced clinical practitioners.

The hospitalists who work at CCH and FH have completed residencies in internal medicine or family practice. Board certification is a requirement at both hospitals.

Cape Cod Hospital also employs a number of pediatric hospitalists and four cardiology hospitalists

“You are probably not aware that theMarcus Welbymodel of medicine has changed, if you are healthy and haven’t been admitted to a hospital since the 1980s,” said Donald A. Guadagnoli, MD, senior vice president and chief medical officer for Cape Cod Healthcare, in a reference to the 1970s TV show about a family medicine doctor.

“Doctors used to rotate between the office and the hospital. For example, when I left my practice in 1998, I was making hospital rounds from 6 to 8 a.m. and again after 5 p.m.,” he said. “People may miss having someone they know shepherding them through the hospital experience. Our hospitalists are highly trained physicians, who are well prepared to care for patients and assist their families during this time anxiety and stress.”

Hospitalists have emerged as a new specialty because medicine has evolved rapidly over the past few decades, according to Dr. Guadagnoli, a trained obstetrician/gynecologist.

“Rapid advances in the science of medicine over the past three decades have driven much of the change. Now, hospitalists are on the floors watching for test results to arrive and interacting with nurses in real time. Hospital-based physicians can respond immediately to new information and changes in patients’ conditions,” he said.

What to expect from your hospitalist

Ricardo Nario, MD, director of Hospitalist Physician Services at Cape Cod Hospital, often answers the question, “Where is my doctor?”

“I have a lot of explaining to do when I meet patients,” he said. “I have to describe my role as a hospital-based physician who only treats patients who have been admitted to our care. I have to start building a relationship and establishing trust with patients and then update them and their families about their care plan.”

A common misconception is that the doctor you see in the Emergency Department is the doctor who will oversee their care, he said. The care plan is established early, and the hospitalist, or now in very rare circumstances, the patient’s own physician takes over after admission to the hospital, he explained.

According to Dr. Nario, Cape Cod Hospital’s hospitalists:

  • Are in the hospital 24/7, ready to see patients.
  • Maintain continuity of care so that patients have the same hospitalists each day whenever possible.
  • Communicate with referring physicians on a case-by-case basis. For example, they call the patient’s oncologist or other specialists as needed.
  • Speak with each patient’s family members as needed.
  • Send electronic medical records to the patient’s primary care physician for follow-up care.

“We are there for our patients, and we return our patients to their primary care physicians after discharge from the hospital,” said Dr. Nario. “Most importantly, the entire hospitalist team strives to deliver exceptional, compassionate care at a time when patients are not feeling their best and need our help the most.”

By BETH ANN LOMBARDI, Cape Cod Health News

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