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Hospitalists’ role growing


Dr. Richard Robus sees anywhere from 10 to 15 young patients a day who are hospitalized at Blank Children’s Hospital. Though none of them are his regular patients, they become his patients while they’re at the hospital.

Robus, who trained in pediatrics, was hired by Blank last year as its first hospitalist, a doctor who specializes in caring for patients while they’re hospitalized.

Hospital medicine, which has been called the country’s fastest-growing medical specialty, is resulting in reduced lengths of stay, lower hospital costs and even reduced mortality rates, according to some research studies.

The specialty, which began in the mid-1990s, has grown to encompass an estimated 7,000 doctors across the country, including at least 107 currently practicing in Iowa hospitals.

“It’s been very successful from our perspective,” said Jennifer Perry, a Blank spokeswoman. “We have received good comments from referring physicians within the community who no longer have to come here to do rounds, unless they want to. It frees them up for more time with their patients.”

Blank added a second hospitalist in March, and plans to add a third within the next year.

Mercy Medical Center was an early adopter of the hospitalist program. Two hospitalists were initially hired in 1997 to handle hospitalized patients for physicians at the Mercy Clinic in Indianola. Mercy now has six hospitalists who serve patients for about 50 family physicians. It’s allowing the hospital to provide better continuity of care, said Dr. Kathleen Moffitt, who was one of the first two hospitalists at Mercy.

“If I admit a patient on Monday, I will see that patient Monday through Friday,” Moffitt said. “By having one doctor always seeing that patient, we’re able to be coordinators of that care.”

Additionally, “we’re very careful about scheduling a follow-up appointment with the family doctor after the hospitalization,” she said.

Iowa Methodist Medical Center and Iowa Lutheran Hospital, which, like Blank, are operated by Iowa Health – Des Moines, each use what they call a “hybrid” hospitalist program. Rather than hiring full-time hospitalists, they have internal medicine specialists devote a week at a time solely to hospital work.

“Studies have found that if the physicians are dedicating 20 to 25 percent of their time to hospital work, the results are about the same (as having full-time hospitalists),” said Dr. Mark Purtle, vice president of medical affairs for Iowa Health – Des Moines.   Currently, 10 internists at Methodist and five at Lutheran serve in the program, which is voluntary at the discretion of the patient’s primary-care physician.

Though cost saving isn’t the primary goal, the program makes the hospital more efficient because the participating physicians are generally there all the time, Purtle said. Additionally, patient satisfaction with the system is good.

“Patients and families like the fact that someone’s around to explain things to them,” he said.   

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