My Father and Hospitalists
Have you or a loved one been admitted to the hospital lately? If so, did you notice that your own personal physician didn’t come to visit you? Did you notice that you were assigned a “hospitalist"? Welcome to the new world of Obamacare. In order to cut healthcare spending, hospitals and large physician groups are combining to drastically expand the Accountable Care Organizations. To maximize profits, hospitals are employing more physicians as hospitalists and subsequently squeezing out your personal doctor.
Though the term was coined in 1996 by Dr. Robert Wachter, chief of the Division of Hospital Medicine at the University of California, San Francisco, the use of this type of impersonal physician care is rapidly increasing due to the new wave of Obamacare. Physicians are flocking to this line of work that lacks the need for compassion and commitment, leaving a huge void in personal physicians. A sign of things to come: in Massachusetts, a patient has to wait 48 days to get an appointment with his own personal internist.
What is a hospitalist? The UC San Diego Department of Medicine states that the Society of Hospital Medicine has adopted the following official definition of “hospitalist”:
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine.
This sounds rather benign, like they are simply educated candy stripers. However, they are actually replicant versions of your kind, caring personal physicians, and their inaccessibility, unaccountability and basic lack of commitment to the patient can have deadly consequences. Most people in America have their own trusted physicians, who know their medical history intimately. In the past, when a patient entered the hospital his own personal doctors were notified and consulted, and this was followed by subsequent visits.
The new method of operation, designed to control hospital costs, is to assign a patient a “hospitalist” -- a physician who knows nothing about the patient’s medical history and is relying on a sick patient, or a frazzled family member, to fill in pertinent gaps in knowledge. The patient is being denied his personal doctor who will not only properly care for him but care about him. The patient is left with an unattached, surreptitious hospitalist who is a “shift worker.” Once the hospitalist leaves the hospital, he washes his hands of the patient, leaving the patient to the next hospitalist on duty. Trying to connect with these revolving-door hospitalists is a nightmare and it leaves a critical void in not only the patient’s care, but in the family’s ability to know when, why and how the patient is being treated and how the patient is faring.
These hospitalists make decisions — prescribing new medicines or altering existing medicines — based on a sketchy history of the patients without consulting their primary physicians. They often do this in a precarious and arrogant manner — the “hospitalist God complex,” or perhaps it is the Obamacare-laden hospital pulling the “God” strings.
I have witnessed this phenomenon firsthand, two times. The first time was with my mother. The second time was with my father, who recently died two weeks after dealing with a hospitalist.
My mother had a bad reaction to a pain medication after surgery. Her trusted physician visited her and instructed all physicians to give her no more medications until the ill effects of the medicine had ceased. After he left the hospital, a hospitalist, having not one ounce of bedside manner, immediately usurped what her physician said and attempted to medicate her in a drastic way — one of the side effects being potential coma. I knew that this was against her doctor’s orders, and with great, exhausting difficulty, I prevented such a potentially lethal action from taking place. It was fortunate for my mother that I was there. Family members cannot always be at the hospital, often leaving dangerous gaps in communication.
The second time I dealt with a hospitalist, the results were deadly. My 79-year-old father had been plagued by many different ailments for many years, yet his team of personal physicians had successfully kept his medications in balance, his ailments contained — and him alive. This all changed when my father was admitted to the hospital -- simply for observation. I was not at the hospital when my father was admitted. The assigned “hospitalists” -- there were different hospitalists every day -- started playing Russian roulette with my father’s medications for no apparent reason. Trying to talk to one of his hospitalists was impossible, and one hospitalist didn’t know what the other hospitalist was doing -- which resulted in conflicting messages and careless care.
One of the hospitalists needlessly prescribed a very risky pain medication (especially risky for an elderly man with an extensive and complex medical history) for an ache that was nominal. None of his personal physicians, who knew of his benign aches, ever prescribed this medication because they knew the potential side effects were severe and potentially hazardous. The ends did not justify the means. Two weeks later my father was dead.
Beware of hospitalists. Though there are certainly well-intentioned hospitalists, they are nevertheless an arm of Obama“care” and a sign of things to come -- impersonal disregard and haphazard protocol. Patients need to be vigilantly aware of the consequences of having a hospitalist — who is often cavalier, overwhelmed, and not personably accountable in any way (the hospitalist will never see the patient again after the patient is discharged from the hospital). This impersonal way of practicing Obamacare can be deadly. It was for my father.