Friday, January 30, 2009

The University of Chicago recognizes the trouble with Hospitalist Program Model

Thank goodness that researchers at The University of Chicago have officially determined what we have all known:
Most Hospital Patients Unable to Identify Their Physicians, Survey Finds

Hospital patients are rarely able to identify their doctors by name or to describe their roles in the patients’ care, a new survey has found.

Researchers at the University of Chicago interviewed 2,807 adults admitted to the school’s hospital over a 15-month period. The patients were asked about the roles of the various physicians attending to them and to name the doctors on those teams. Medical teams consisted of three to four people, including medical students, residents and attending physicians.

Some 75 percent of the patients were unable to name a single doctor assigned to their care. Of the 25 percent who responded with a name, only 40 percent were correct. Those patients who claimed to understand the roles of their doctors were more likely to correctly identify at least one of their physicians.

“I was not so surprised,” said Dr. Vineet Arora, assistant professor of medicine at the University of Chicago, noting the frequent shift changes and the bustling nature of a hospital that often patients lose track of their doctors.

Carol Levine, director of the families and health care project of the United Hospital Fund in New York, noted that the study failed to mention the role of family caregivers in a hospital setting. “In a way, the patient is in the worst position possible to make notes and jot down names,” said Ms. Levine. “But family members are often involved, and they’re the ones running down the hallway to track down a doctor.”

But even family members cannot always keep track of medical team members. “Caregivers aren’t always there, especially late at night and early in the morning,” said Dr. Arora. Hospital rounds often take place quite early, she noted, before family members have arrived.

Whether patients need to be familiar with hospital staff is open to debate, according to some experts. “Do you really need to know who your doctor is, or is it more important to know some processes that will help you get at the information you need?” said Dr. Ernest Moy, medical officer at the federal Agency for Healthcare Research and Quality.

In the new study, patients able to name one of their physicians also were more likely to be unsatisfied with their care, the researchers found. “In some ways ignorance is bliss,” said Dr. Moy. “We assume when you walk into a hospital you are going to be taken care of, but maybe we put a little too much faith in hospitals.”

The study was published on Monday in the Archives of Internal Medicine.

Nowhere in the article (and presumably the study) is the issue of "hospitalists" discussed.

In fact, patients do not know the names of their physicians because their physicians are not allowed to follow them in hospitals. The sick and vulnerable patients are in a room with (hospitalists hate this term) "stranger doctors" coming in and out.

The "stranger doctors" that I have encountered have been focused on being cost effective and moving the patient out of the hospital. The "stranger doctors" that I have encountered actually (to my face) refuse to communicate with the treating and even the admitting doctors.

The Hospitalist Program Model came into use under the radar. Consumers of medical services (patients) were never asked about this Model that would effectively mean that you do not know your hospital doctors.

So what is next? Watch out for the implementation of Federal Medical Boards. If Obama and Daschle get their way (and Federal Medical Boards are charged with treatment decision making) then the delivery of medical care as we know it will be over.

Have you bought your copy of Tom Daschle's "Critical: What we can do About Healthcare?"

No comments:

Post a Comment