Thursday, January 1, 2009

Should a stranger doctor care for me in the hospital?

I encourage all of you to "google" the term "hospitalist." Figure out for yourself what a hospitalist is and how that person fits into a hospital stay.

The whole concept (hospitalist program model) has a history and the implementation into our nation's hospitals has been under the radar of the general consumer of medical care. We should not be expected to accept a stranger taking care of us in the hospital.

If the hospitalist program model is the best way for our hospitals to be run, then the hospitalists should explain it rationally to the public. Someone should make the case for the program. Hospitalists and hospital administrators should not cram stranger doctors down our throats and then be surprised when patients are confused and displeased.

Please realize that the patient is the most important person in the hospital setting. Sometimes that person is you and sometimes that person is a loved one.

You absolutely have a right to be treated by the doctor of your choice. Talk to your primary care doctor. Discuss your concerns about who will care for you when you are in the hospital.

If you want your hospital care to be under the watchful eye of a relative stranger who knows nothing about your medical history then you will be fine with a "hospitalist."

If, however, the thought of a stranger taking care of you during a hospitalization is upsetting, then find out your options. You may be able to admit to a hospital where you essentially forbid the stranger from having major decision making power over you.

Sure, the stranger doctor could okay a change in your diet or prescribe some basic medications (just like a PA or NP). But, you may want all of the major decisions, including the decisions about your discharge, to be made by a doctor who will actually see you post discharge. The doctor who sees you post discharge has some accountability and interest in your having a satisfactory hospital stay.

Finally, if you are in the hospital and the stranger doctor (hospitalist) who is caring for you (or your loved one) is rude, offensive, uncommunicative or treating the patient poorly . . . make noise and make sure that the patient is not subjected to any mean person. The patient has that right. Fire the hospitalist right there in the hospital. The patient always deserves to be treated
with respect and dignity.

I have absolutely told mean, disrespectful hospitalists to leave my father's hospital room. I refuse to allow hospitalists (or any doctor) to mistreat my father. And, we, the caregivers are not dopes. We know when our loved ones are unsafe. Sometimes they are unsafe in the hospital! I have always demanded that my dad be safe.

In my experience, that safety is best achieved by my father being followed during hospitalizations by his actual treating clinicians (as opposed by the stranger hospitalist doctor). When the clinic doctor cannot make rounds everyday, the residents and fellows step in. That is the benefit of a teaching hospital.

As our population ages and the Obama administration ponders health care reforms, remember please always remember that the patient matters.

You really do have some control over your health care and hospitalization. Our country has not adopted national health care - yet.

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