Tension or teamwork? A primary care physician and a hospital sit down for an honest exchange about what's working — and what isn't — when coordinating patient care.
Hospitalists are among the fastest-growing medical specialty groups in the United States. In recent years, primary care physicians have raised concerns about care coordination with these clinicians.
Medscape conducted separate interviews with a primary care physician and a hospitalist to explore the challenges these two specialties face. The primary care physician was interviewed first, and excerpts from that interview were then shared with the hospitalist for comment. We then invited each physician to respond to each other's statements. This dynamic exchange led to a thoughtful and surprising conclusion. My name is Dr Albert Levy and I am an assistant clinical professor at Mount Sinai.
In our current location, we started with six hospitalists in the year 2000 and we currently have 76 hospitalists in our group. We were originally taking care of 25 patients a day, on average, and now it's well over 500. The patient I'm going to see this afternoon — I've been his doctor for 40 years. He doesn't want to see a hospitalist who he's never met in his life.
What's happening now is I get a note from the hospital 5 days after my patient was admitted with, say, a. Then, I'm calling the patient and asking, "What happened to you? I didn't know you were in the hospital." And the patient will respond and say, "Well, I couldn't call you because I was kept in the hospital." They don't even know the name of the doctor who's looking after them.
I think it's very important for me to be notified when a patient has been admitted, as soon as possible. I don't want to wait 24 hours, and the best notification, for me, would be a telephone call. Real-time completion of a complete discharge summary is really what we strive for in order to make sure that the primary care physician is aware of what went on during the hospitalization and they know in real time when the patient is leaving.
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