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Hospitalist programs gaining on Cape Cod and elsewhere
In-hospital M.D.s
provide service
for patients and
their physicians
By David Reiily
CONTRIBUTED PHOTO
HOSPITABLE HOSPITALIST - Saralyn MacKenzie, M.D., heads the
hospitalist program at Cape Cod Hospital.
A Hospitalist is a hospi-
tal-based physician who is
designated by a primary care
physician to follow a hospital
patient whenthe primarycare
physician is unable to do so.
Sometimes referred to as a
House Physician, a hospi-
talist is board-certified and
experienced. Often trained in
internal medicine, hospital-
ists work in the hospitals in
shifts and are responsible for
making admissions from the
emergency department to the
hospital floor, and also treat-
ingpatients who have already
been admitted.
Severalyearsago,Cape Cod
Hospital-aswellasFalmouth
Hospital -introduced Hospi-
talist Programs as a way to
provide uninterrupted quality
care for hospitalized patients,
and to help ease the time
burdens facing manyprimary
care physicians.
"A hospitalist is a tremen-
dous asset to patients on the
Cape because we are in the
hospital every day and we are
more familiar with hospital
policiesand procedures than a
primary care physician in the
community might be," said
SaralynMacKenzie,M.D.,who
heads the hospitalist program
at Cape Cod Hospital. "Asare-
sult, we're able to streamline
and improve patient care.
"The important point to
remember," she added , "is
that the hospitalist is an ex-
tension of your physician,not
areplacement. Thehospitalist
consultswiththe primarycare
physician on all aspects of a
patient's care and helps the
primary care physician make
informed decisions about
a patient's treatment and
recovery."
Cape Cod Hospital now of-
fers 13hospitalist doctors on
staff.They serve the following
groups:
• Mid/Lower/Outer Cape
physicians and patients
• Visitors and vacationers
to the Cape
• People without Primary
Care Physicians (PCPs)
• PCPswithadmittingprivi-
leges
• Subspecialists
The hospitalist practice is
growing busier each year.For
example, in fiscal year 2006
(Oct. 1,2005to Sept. 30,2006),
the hospitalist group at Cape
Cod Hospital admitted 5,514
patients through the Emer-
gency Department. All told,
the hospitalists now do 73
percent ofmedicaladmissions
at Cape Cod Hospital.
Advantages for
Patients
Hospitalists are immedi-
ately available and can see
a patient multiple times per
day. They are very familiar
with the ins and outs of the
hospital and have access
to all hospital specialists ,
departments and services.
And because they are based
in the hospital, they are very
comfortable taking care of
sick patients.
"Patients can be comfort-
able," MacKenzie said, "in
knowing that the hospitalist
willshare withthem and their
loved ones communication
that takes place with their
physicianand subsequent de-
cisions that are made about
their health care."
Of course, patients play
an important role in their
hospital treatment. "It is
important ,"said MacKenzie ,
"for patients to have a list of
updated medications with
doses and schedules, and if a
patient receives primarycare
outside of the Cape network ,
they should also carry amedi-
cal history with names and
numbers of doctors. "
Advantages for
Primary Care
Physicians
The trend to use hospital-
ists is growing throughout
the country, driven by forces
such asinefficient commutes
for primary care physicians,
more time demands on PCPs,
and the need for greater in-
patient expertise.
The unique geography that
attracts many people to Cape
Cod also makes timely travel
difficult for doctors from
towns that are far from Cape
Cod Hospital. The four Outer
Cape towns of Eastham ,
Wellfleet, Truro and Provinc-
etown are farther away from a
hospital than any other towns
in Massachusetts.
Additionally, doctors often
have to attend to medical
emergencies or have a full
schedule of patients dur-
ing practice hours. Because
of geographic realities and
demanding schedules, physi-
cians at times have difficulty
following their patients who
are hospitalized , meaning
the role of the hospitalist
is perhaps more important
on Cape Cod than in other
regions.
"Hospitalistshelpimproved
efficiency for PCP practices,"
said MacKenzie. "They have
less travel time, can spend
more time in their offices, and
don't have to admit patients
in the middle of the night. In
addition , patient and family
members have a heightened
sense of security because of
the presence of experienced
doctors around the clock."
Cape Cod Hospital' s hos-
pitalist physicians are avail-
able 24 hours per day; seven
days per week; 365 days per
year. When a patient is dis-
charged , the hospitalist will
discuss withthe primary care
physician ongoing treatment
needs , including follow-up
treatment , medication , reha-
bilitation and home health.
And if a patient does not
have a local physician, the
hospitalist can help them
find one. If you would like
further information on the
Hospitalist program at Cape
Cod Hospital , call 508-862-
5976.
The writer is communications director
for Cape Cod Healthcare.
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