Who is better suited to look after you during a hospital stay: your primary
care doctor or a doctor who specializes in caring for patients in hospitals?
You may be surprised to learn a recent study’s answer to that question.

Traditionally, your primary care doctor admitted you to the hospital and
looked after you throughout your stay. However, over the past few decades,
increasing cost pressures have made such an arrangement less common. More
and more patients are admitted and cared for by hospitalists, internal
medicine doctors who only practice in hospitals. The idea is that hospitalists
can most efficiently coordinate care, thereby reducing the length of a
patient’s hospital stay and keep costs down.

What is lost with the hospitalist approach, of course, is the personal
knowledge your primary care doctor has about you. He or she not only has
superior understanding of your health history, but also knows more about
your emotional needs and likely has some relationship with your family
members. These aspects of the physician-patient relationship can be crucial
during life-threatening problems in the hospital, and could easily be
underserved when a hospitalist manages your care.

For the first time, a recent
study looked at whether care by a hospitalist actually leads to increased medical
care cost savings, as claimed by insurance companies and others. The results
were surprising. The study, which appears in the August 2, 2011 issue
of The Annals of Internal Medicine, found that patients cared for by hospitalists
were less likely to be discharged home rather than to a rehabilitation
or nursing facility. It also found that patients cared for by hospitalists
were more likely to have emergency department visits and readmissions
after discharge.

The study concluded that any decreased length of stay and hospital costs
associated with hospitalist care were offset by higher medical utilization
and costs after discharge.

So what is the bottom line for patients? Whether you are being cared for
by your primary care doctor or a hospitalist, it is important you advocate
for yourself or your loved ones. Make sure your regular doctor communicates
with the hospitalist and is aware of everything he or she should know
with regard to your medical history and treatment. After you are discharged,
make sure your doctor knows what went on during your hospital stay.