The term “hospitalist” was coined in 1996 by Robert Wachter and Lee Goldman in a New England Journal of Medicine article to describe a physician who manages the care of hospitalized patients.
Most hospitals in the united states have hospitalist as their primary admitting and managing service (Chippenham included). We admit and mange a vast array of medical conditions; often with consultant sub-specialist depending on the patient’s need.
Hospitalist are analogous to primary care doctors (PCP) who only work in a hospital; we do not have outpatient clinics. After college we go to medical school then onto a residency program; most in internal medicine though family medicine trained physicians are hospitalist too. Hospitalist are board certified like all practicing doctors; our focus is on care of hospitalized patients which involves more acute diagnosis and management. Where a PCP does the same but also focuses on long term preventative health. By definition all the patients who see a hospitalist are sick enough to be admitted to a hospital.
An often used football analogy likens hospitalist to a quarterback. Maintain a vision of the entire situation, act directly, assist others, keep the goal in mind. We coordinate with the entire healthcare team to address all aspects of care. It is not unusual to speak with a specialist, case manger, nurse, physical therapist, and pharmacist on the same day. Caring for the patient involves taking into account their medical, social, financial, emotional, familial situation and how each influence the other. As a general internist I enjoy these varied aspects of care which often require the “art” of medicine; not just the science.
At Chippenham Hospital the PCP is notified at discharge (usually via secure email or fax) with a discharge summary. This is short document written by the hospitalist which summarizes the patient’s hospital stay including diagnosis, treatment plan, what happened, any problems, and next steps. It includes the discharge medications and relevant imaging or lab work done during the stay.
The hospital never closes and thus Hospitalist must staff 24 hours/day 7 days/week. To accomplish this Hospitalist work in shifts generally either the day shift or the night shift. For instance at Chippenham Hospital we seven days in a row and then are off for seven days. A week off at a time it’s nice, it’s necessary to recover from a very high intensity 84 hour work-week twice a month. Our usual switch day is Thursday.
Dr. Montgomery's Patient Education Site 