Hospital Medicine: A Growing Specialty

By: Margie Coloian

As health care reform takes shape, one of the medical specialties that could have an enhanced role is that of hospital medicine. Also know as Hospitalists, these specialists care for patients while they’re in the hospital. They aim to expedite treatment and improve communications among all of the patient’s providers during a hospital stay. Because they are so familiar with the hospital setting, they often suggest important changes to procedures and protocols that help to improve and streamline patient care.

Chi-Cheng Huang, MD, recently joined Lahey Clinic as the Chair of the Department of Hospital Medicine. Today, he answers common questions regarding this growing specialty.

Q: Does the hospitalist replace my primary care doctor while I’m in the hospital?

A: A hospitalist, who is assigned at the time of your admission to Lahey Clinic and who follows you through discharge, communicates closely with your PCP, updating him or her on your status and changes in treatment. Because PCP’s see patients in their offices most of the day, they cannot be at the bedside as frequently as your hospitalist, who is based on the hospital floor. When you’re discharged, you will receive instructions, including medications you will take, from your hospitalist.

Q: Can I follow up with my hospitalist instead of my PCP?

A: No, the hospitalist turns over a summary of care to your PCP, and your PCP follows up with you from then on.

Q: What advantages are there to having an hospitalist?

A:  Physicians who see inpatients every day have a distinct combination of knowledge, skills and relationships. They know how to help the patient quickly and provide continuity of care from floor to floor or service to service, reducing hand-offs (when one medical specialty sees the patient and then turns the patient over to the next specialty for assessment or treatment). He or she is readily available for consultations, communicating with family members, and taking immediate action when a patient’s status changes.

Q: How many hospitalists work at Lahey and how many patients do they each see every day?

A: There are currently 17 hospital medicine specialists at the medical centers in Burlington and Peabody, and each sees about 12 patients a day. Often the hospitalist sees a single acutely ill patient several times a day, reassessing treatment and making changes to the care plan as needed. There are about 30,000 hospitalists currently practicing in the United States, according to the Society of Hospital Medicine, which was founded in 1998.

Q: Do these doctors have any special training?

A: At present, they are board-certified in internal medicine, but there are some fellowship programs in the specialty.

Q: Have there been any studies done demonstrating  the effectiveness of hospitalists?

A: Clinical studies consistently show that hospitalists improve quality of care, reduce unnecessary days spent in the hospital and decrease overall costs of care. They are also instrumental on hospital improvement committees because of the marked familiarity they have for how individual hospital systems work

Dr. Huang

Dr. Chi Huang has spent the last fifteen years advocating for the lives of marginalized and impoverished children in developing countries. Since 1997, he has worked with street children in Bolivia. His research interests lie in determining the socioeconomic risk factors of abandoned street children, studying their health care needs, and documenting human rights abuses. He is the president and founder of Kaya Children International (www.kayachildren.org) a nonprofit organization. Additionally, Dr. Huang is the chairman of the department of hospital medicine at Lahey Clinic.