Wednesday, March 27, 2013

The Hospitalist phenomenon

Only in recent years have I been aware of the term hospitalist.  That's an MD who specializes in nothing yet administrates the paperwork of a patient's care, entry, and exit.  They may see the patient that they are the ultimate decision makers for, maybe, three times over four days for 1 minute max each time.  They are for the most part just hired by the hospital to work regular hours, at good salaries but without the "burden" of really needing to know the patients or work unpredictably long hours.  At around $200,000 a year for this admin job that is crucial to the patient but not to them it may be a good gig.  I guess this started because fewer and fewer MD's are actually primary care doctors or internists, that not being where the money is especially when it comes to Medicare, disability, any other federal program or comprehensive insurance plans.

With my mother tangentially, with my father totally over two years, and myself with some issues, the hospitalist has become a familiar problem.  They relieve all of the specialists who may or may not be needed of the effort to spend any time with the patient, maybe 30 seconds at best, and they report to the  hospitalist what drugs they recommend based on the constant tests one is given in the hospital.  They eventually decide to discharge a person based on protocols no less rigid than a call to a Citibank card representative in India.

No one is responsible for explaining what the drugs prescribed are for, unless one of the doctors has an unusual display of caring about who their patient is.  Wrong prescription, far too heavy doses, completely unneeded medication, or simply not what was understood, we learn about it at the local pharmacy and once a patient has been released from the hospital they refuse to change them or deal with their mistakes.  The hospitalist just aggregates the prescriptions and sends you home, no explanation needed.  Just do what you are told could certainly be the mantra of hospitals in this area and in Virginia, you are not competent enough to understand.  This it should noted is not an Obamacare event, it had already started and is firmly in place.

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