Hospital Medicine

Lahey’s hospitalist group includes more than a dozen physicians and a physician assistant. When you are admitted to the hospital, you will be assigned to a hospitalist who will oversee your care from admission to discharge. This doctor will see you daily or more often depending on your needs.

The hospitalist will collaborate with your primary care physician and collect information from your medical record to develop your treatment plan. Hospitalists will also coordinate your care whenever surgeons or other medical specialists are needed. When you are discharged from the hospital, the hospitalist will transfer your care back to your primary care physician and arrange any necessary follow-up appointments.

Begun in 1999, Lahey Hospital and Medical Center’s hospital medicine group offers inpatient medical care 24 hours a day, seven days a week, 365 days a year at Lahey’s main campus in Burlington, Mass., and Lahey Medical Center in Peabody, Mass, as well as at Beverly Hospital and Addison Gilbert Hospital in Gloucester. The group is responsible for medical consultation in internal medicine to other services in the hospital. Hospitalists also play an active role in the education of internal medicine residents and medical students from Tufts University School of Medicine.

The hospitalist's expertise and experience in caring for ill and injured patients results in improved quality, efficiency and reduced length of stay. Benefits of hospitalist care include:

• expedited diagnosis and treatment while you are in the hospital
• improved communication between you and your family and the team of doctors and nurses caring for you
• immediate action if test results are abnormal
• immediate response if an emergency occurs while you are in the hospital
• timely discharge

Hospitalists are also quality and safety leaders that work to reduce the potential hazards of medical care, such as hospital-acquired infections and medication errors. Studies have demonstrated improved clinical outcomes under hospitalist care compared to older models of care.

Hospital medicine has been available at Lahey Clinic in Burlington since 1999. But today hospital medicine is an official clinical department. The department has a dedicated, collaborative team of physicians who are available to care for inpatients at Lahey Hospital & Medical Center in Burlington and Lahey Medical Center, Peabody.

When a patient is admitted to Lahey, a hospitalist is assigned to that patient through the Emergency Department or through the clinic itself, and oversees care from admission and often discharge. Unlike a primary care physician (PCP), who may visit inpatients before or after clinic hours, the hospitalist is on site all the time and readily available to expedite treatment, improve communication between providers and family members, and take immediate action when test results are abnormal.

Coordination with PCPs

The hospitalist does not replace the PCP. In fact, the hospitalist communicates regularly with the patient's PCP, either by e-mail or phone to alert him or her to changes in the patient's condition or treatment. Comprehensive reports, including initial evaluations and discharge summaries, are also sent to the PCP in a timely fashion. On discharge, patient instructions are given and medications are reviewed by hospitalists. The patient then returns to the care of the PCP.

Physicians who see inpatients every day have a distinct combination of knowledge, skills and relationships, noted one hospitalist. "They know how to gain access for certain services in the hospital for patients very quickly because they know the hospital system well and know what additional services or consultations are clinically indicated."

Better patient care

Clinical studies have consistently shown that hospitalists improve inpatient quality of care, reduce unnecessary days spent in the hospital, and decrease overall costs of hospitalization.

Quality committees, in particular, at many hospitals like Lahey, can benefit from these specialists serving on their panels. Hospitalists are well positioned to examine wider processes throughout their hospital system, based on their frequent exposure to care delivery, and may recommend changes when needed to improve systems. Hospitalists also provide the continuity of care from floor to floor, or service to service, thereby reducing the number of handoffs from various specialties. They also play an active role in helping to educate Lahey's internal medicine residents and medical students.

The average Lahey hospitalist sees 13 patients a day-usually multiple times a day, per patient, based on changing laboratory results or symptoms.

At present, hospitalists are board-certified in internal medicine; there are however, fellowship programs in hospital medicine.

The Society of Hospital Medicine, founded in 1998, estimates there are 28,000 hospitalists in the US. As baby boomers continue aging and as demand for inpatient hospitalization grows, so too will the number of physicians entering the field.

• Telephone: 781-744-3839
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