Page 13 - Hospitalists - Risks When You're the Doctor in the House (Part One)

SVMIC Hospitalists - Risks When You’re the Doctor in the House

Hospitalists are increasingly involved in the care

of patients who otherwise would belong to a
different line of service, such as general surgery

or orthopedics or neurosurgery, or, rarely,
obstetrics. The patients of hospitalists tend to be

sicker than those of primary care physicians given that they are
already hospital inpatients. They tend to have co-morbidities

and are often poor historians who have presented through the
emergency department.

In addition to hospitalists having to do things they are not

comfortable performing, there is also the increased pressure
from most hospital administrators to see more patients each

day. Having 15 or fewer patient encounters a day is a rarity for
physicians, unless they are working at a critical-access facility or

a small hospital with fewer than 30 beds. On average, the norm
for most hospitalists is 18-20 patient encounters a day.
7

An early study published online in JAMA Internal Medicine,
reported that more than one-third of hospitalists admitted

carrying an unsafe patient load more than once a week,
leading to poor communication, treatment errors, potentially

unnecessary tests, sloppy handoffs, complications, and death.
8
The online survey of 890 self-identified hospitalists found that

40 percent said their typical inpatient census exceeded safe
levels at least once a month, and 36 percent said it happened

more than once a week.
9

The same study noted that the unsafe workloads often had
patient safety consequences and, accordingly, the potential

7 Id.
8 JAMA Intern. Med. 2013;173(5):375-377.
9 Id.

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