READERS' FORUM
Hospitalist experience interesting
To the Editor:
I have watched with some interest the growing debate over hospitalists versus generalists who do their own inpatient care.
I participated in a group of hospitalists in United and Children's Hospital in St. Paul in 1995-96 while a staff physician at the Westview Clinic (with 11 doctors -- all FPs -- and four physician's assistants at the time). Our group was approximately 20 physicians who did a week on service about every seven to eight weeks. We had several physicians who worked part-time on the service, generally for weekend and night call. Our director generally paired an internist with an FP to facilitate coverage of our Children's Hospital needs.
I personally found the week on the service to be extremely demanding of time and energy, but it focused my hospital skills to a degree not seen since residency. In general, I agree with both the benefits and questions described in President Brooks' Q and A in the January FP Report. However, the hybrid service (both office and hospitalist) made both more interesting.
In addition, I worked part-time in the very busy emergency department of this large teaching hospital. As an ED physician, the hospitalist was a godsend, as the service took all out-of-town and non-staff attendings' admissions. Our director, Dr. Scott Tongen of Woodbury, Minn., and the physicians on the service were careful to notify the personal M.D. at least twice a week routinely and for significant changes in any patient. Some patients did complain about not seeing "their doctor," although I did care for several of my own patients during my several weeks spent in the hospital over the period of 15 months on the service. In general, this version of hospitalism seemed to be a very viable system, largely due to the efforts of the director and the team of hospitalists.
ROLF NALEY, M.D., M.S., Sherman, Texas
FP Report is published by the AAFP News Department. Copyright © 1998 by American Academy of Family Physicians.