What are your thoughts on hospitalists? Some people insist they are always a better option over primary care physicians, while others maintain patients are always better off being treated by their own doctors. The two extremes deny the true nature of hospitalist care and its potential benefits for patients and hospitals alike.
A 2017 study out of Harvard Medical School clearly shows that both extremes in the hospitalist debate are just that: extremes. Researchers say that hospitalists can be the better option sometimes. But there are occasions when it’s better for patients to be treated by their own doctors.
The results of the study shouldn’t be surprising to people who understand the ins and outs of medicine. Like almost everything else in the medical industry, there are no black-and-white statements that apply in every situation. The 2017 Harvard study proved that.
Numerous studies over the years have shown that employing hospitalists is good in many ways. For example, hospitalists tend to contribute to shorter stays in hospitals. For reasons that are not fully understood, patients are less likely to stay in the hospital longer than they have to when being cared for by a hospitalist.
By the same token, patients looked after by hospitalists are less likely to be readmitted shortly after being discharged. Again, the reasons behind this are not quite clear. It could be that patients just do not want to go back to the hospital and be treated by a strange doctor. But it could also be related to the kind of care hospitalists provide.
Finally, studies have shown that shorter stays and reduced readmissions are good for a hospital’s bottom line. Hospitals actually save money when they employ hospitalists rather than bringing in primary care physicians to oversee patient care. Replacing the primary care physician with an employed hospitalist removes the ‘middleman’ so to speak, thus streamlining care and saving money.
What the Harvard study looked at was patient response by demographic. Interestingly enough, the researchers determined that some patients, particularly older patients whose care is covered by Medicare, tend to do better when care is supervised by their primary doctor.
The Harvard study showed that approximately 11% of patients cared for by hospitalists passed away within 30 days of discharge as compared to 9% cared for by their primary doctors. Statistically speaking, the difference is not big enough to be alarming. Still, it is a measurable difference.
Likewise, 36% of the older patients cared for by hospitalists were transferred to long-term care upon discharge as opposed to just 30% of patients treated by their primary care physicians.
Researchers speculate that the differences in both statistics may be related to the patient’s willingness to receive treatment under the supervision of a hospitalist as opposed to their own doctor. We do know that attitude and mindset do play a role in health, so it could be that those patients who receive care at the hands of their own doctors are more confident in their recoveries and, as a result, respond better to treatment.
It would be easy to cite statistical data in defense of one form of hospital care over another. But at the end of the day, the lesson is clear: different situations call for different measures. There are certain situations in which a hospitalist is the better option for providing care. In other cases, it is better that care be overseen by the patient’s primary physician. That’s not a cop-out, it is medical reality.