There are many frustrating aspects of dealing with a hospitalization, whether you, your child or your parent is the patient. One of the most challenging aspects is the entire lack of control, from having no say on the room location or nurse, to never knowing when there is going to be a knock on the door and a new face to meet, another opportunity to recite one’s story.
Earlier this week our CMO, Ryan Secan, MD, shared an interesting thought piece in the ACP Hospitalist magazine on how hospitals might be able to reduce or eliminate some of the lack of control that looms large during a hospital admission: provider continuity. For any adult child that has found him/herself trying to cope with a sick parent in the hospital, I’m sure this scenario rings true:
Child – “Was the doctor in today?”
Parent – “Yes someone in a white coat was here this morning”
Child – “Which doctor was it?”
Parent – “I don’t know”
Child – “What did he/she have to say?”
Parent – “I don’t know, I was asleep”
And there you have it. I had this happen more times than I could count with my father over many admissions. So as I read Dr. Secan’s piece, the wild notion of the same doctor over each admission, or at least many of them, would have alleviated some of my frustration around never really feeling like I knew what ‘the plan’ was. I say wild because let’s face it, it sounds almost outlandish to think that there could be continuity in the acute care setting like there is in the office setting but guess what, it isn’t that farfetched given that patients tend to seek care at one hospital, with a central registration system, staffed by a team of providers, who are scheduled by technology.
Think of the benefits of re-orienting hospitalist medicine towards an inpatient PCP: better knowledge of the patient and his/her medical and social intricacies, relationships with family members who will play a vital role at discharge, and more alignment with the patient’s true PCP that too will play a central role in managing any new or chronic conditions moving forward – and ideally keeping the patient out of the hospital.
As Dr. Secan says in his piece, “While the inpatient and outpatient worlds are different, patients are still patients, and we shouldn’t be surprised that patients prefer to see a physician they know rather than a stranger.” Think about how scary a hospitalization can be – and ponder the comfort that a familiar face might offer to someone at one of life’s most vulnerable moments.