tag:blogger.com,1999:blog-18943510.post3338057846480342260..comments2023-08-21T02:57:37.362-05:00Comments on Dr. Wes: When the Hospitalist Service is CappedDrWeshttp://www.blogger.com/profile/17438019699222125477noreply@blogger.comBlogger13125tag:blogger.com,1999:blog-18943510.post-47104593555705213052022-01-05T11:20:11.975-06:002022-01-05T11:20:11.975-06:00Reading this from the perspective of working in a ...Reading this from the perspective of working in a completely unsafe ED with 1:20 nursing ratios, 50 patients for one attending and two residents, 20 admissions and multiple ICU boarders while the hospital teams maintain their usual staffing and care for differentiated patients makes me think everything is backwards. Why do the undifferentiated get the short staffing and least-safe conditions? Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-20951093575074653782010-01-30T19:37:18.099-06:002010-01-30T19:37:18.099-06:00As a recruiter, I've seen the popularity of ho...As a recruiter, I've seen the popularity of hospitalists vastly increase over the past few years. We can certainly use a few more Hospitalists here in Texas!Recruiter Markhttp://sanantoniohospitalistjobs.comnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-66322786337019014692010-01-23T09:32:35.284-06:002010-01-23T09:32:35.284-06:00anon 32. The next time you're coding and you&...anon 32. The next time you're coding and you're waiting for your community family practice or internist to return your call to find out what to do next, remember a hospitalist just saved your life. <br /><br />I suppose every doctor that takes care of hospitalized patients are highly paid residents, considering that's were most of residency training occurs.The Happy Hospitalisthttps://www.blogger.com/profile/14392872203166584371noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-61327405743922626402010-01-23T09:29:35.763-06:002010-01-23T09:29:35.763-06:00stalwart. It's not about limiting the number ...stalwart. It's not about limiting the number of patients. It's about hiring enough doctors so a cap is unnecessary.<br /><br />If I was starting the day at 20 patient a day, I wouldn't cap myself, but I wouldn't accept it either. These kind of numbers, routinely, indicated that more bodies are needed in the trenches. If the hospital is unwilling to subsidize more bodies, I'The Happy Hospitalisthttps://www.blogger.com/profile/14392872203166584371noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-14417685238496364042010-01-22T17:32:23.244-06:002010-01-22T17:32:23.244-06:00@Dr. Wes --
I was coming at this from the standpo...@Dr. Wes --<br /><br />I was coming at this from the standpoint of a single academic hospitalist at a teaching institution, and that it may be very reasonable for an individual attending physician to have a limit to the number of contacts in a given day, for the reasons I cited above.<br /><br />However, our division does not cap or refuse admissions per se -- if all hell is breaking loose, we Stalwart Hospitalistnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-82980803829246678892010-01-22T13:24:01.697-06:002010-01-22T13:24:01.697-06:00@geena and anony 12:48-
The patient was being fol...@geena and anony 12:48-<br /><br />The patient was being followed on behalf of primary care physician for management of CHF by a nurse practitioner in our clinic since patient had significant confounding clinical problems (sorry, for privacy, can't go into details here).<br /><br />Yes I could write orders and transfer his care to myself, but patient had others (including a cardiologist) who DrWeshttps://www.blogger.com/profile/17438019699222125477noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-72779078151872095582010-01-22T12:48:41.585-06:002010-01-22T12:48:41.585-06:00Dr. Wes, I don't mean to put you down, but don...Dr. Wes, I don't mean to put you down, but don't you have admitting privileges? It sounds like your patient should be under your care (or that of another cardiologist) in the hospital.<br /><br />- practice managerAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-37344211981796725272010-01-22T08:32:38.948-06:002010-01-22T08:32:38.948-06:00Inpatient specialists? blah. That appellation can ...Inpatient specialists? blah. That appellation can only be extended to a few of this tribe. <br />Most community hospitalists are just mill-hands doing shift work and waiting for the siren to blow.Their use of resources is no better than the old farts now ensconced in their offices living out the twilight of their professional years. Most use the specialist for all but the most trivial problem.<Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-47204068918186189412010-01-22T01:25:40.834-06:002010-01-22T01:25:40.834-06:00A consultant has to turn me down just once before ...A consultant has to turn me down just once before I drop him from my list of preferred consultants. <br /><br />So I never turn down admit requests. If the work load is too high, the bosses need to hire more docs.<br /><br />-Steve, hospitalistSteve Parker, M.D.http://advancedmediterraneandiet.com/blog/noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-34804034312369957162010-01-21T23:22:52.244-06:002010-01-21T23:22:52.244-06:00Happy --
There comes some point where the gain in...Happy --<br /><br />There comes some point where the gain in revenue obtained by admitting one more patient is outweighed by the increase in risk to the already existing inpatients by the hospitalist having spread himself or herself too thinly.<br /><br />Resident services have caps in order to avoid sacrificing educational capacity of ward rotations to potentially unlimited service needs. WhileStalwart Hospitalistnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-88250404520378561262010-01-21T22:29:40.930-06:002010-01-21T22:29:40.930-06:00The question that came to my mind is if the servic...The question that came to my mind is if the service is busy enough to cap, then they should also be profitable enough to hire more hospitalist and become "uncapped."Mehulhttps://www.blogger.com/profile/10328314445113652828noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-5600164540776394042010-01-21T20:11:08.056-06:002010-01-21T20:11:08.056-06:00I know you said you had a busy clinic day, but how...I know you said you had a busy clinic day, but how long does it take to admit a patient and write a few orders to get them settled until you can get to them?<br /><br />Not trying to be snarky... I don't really know what goes into directly admitting a patient to the hospital.geenahttp://www.codeblog.comnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-34639740661058104252010-01-21T19:43:59.484-06:002010-01-21T19:43:59.484-06:00Ah. Our service would never cap itself. Not in a...Ah. Our service would never cap itself. Not in a million years. A service that caps itself is a sign the hospital needs to pony up some more economic support to support more hospitalists.<br /><br />It's as simple as that. Those that don't will lose big time. For example, sending your patient to another hospital that does have a hospitalist willing to accept them.<br /><br />Thos The Happy Hospitalisthttps://www.blogger.com/profile/14392872203166584371noreply@blogger.com