Headed to Hospital? 4 Key Questions to ask your doctor
Doctors do the best they can to keep patients healthy and out of hospital. Sometimes, though, hospitalization is needed despite the best care possible. At first I joined private practice after training of residence, my colleagues and I have admitted patients in a local hospital and took turns caring for those who needed residential care. This system ensured Wed have easy access to their medical records before and often know them on a personal level. Arranging appointments office after discharge was almost never a problem, and we were guaranteed an understanding of what happened to our patients in the hospital.
That's all changed. The way patients receive hospital care has changed radically in the last 15 years. Many primary care physicians, pressure to take on more patients and exhausted from too many nights on call, stopped seeing their patients through a hospital stay. Instead, they now rely on "hospitalists," a relatively new breed of specialists to exclusive responsibility to care for patients in hospital.
[Preparing for Your Hospital Stay]
There are potential advantages to be treated by a hospitalist rather than a family doctor. Because hospitalists spend their time on the wards rather than trying to juggle obligations to patients in hospital and office, they're usually easier to reach with questions or concerns. Also, hospitalists may be more up-to-date on the latest medical research from residential treatment. These advantages should theoretically translate into better care and shorter stays for hospital patients. And they do, according to a 2007 study published in the New England Journal of Medicine, researchers found that patients cared for by hospitalists had shorter stays indeed hospital and medical costs lower than those cared for by primary care physicians.
But as hospitalists are replacing family doctors on hospital wards, concern is mounting that poor communication between the hospital and doctors office can lead to worse health outcomes after discharge. I personally know the frustration of seeing patients in office after recent hospital did not receive critical information about what medication changes were made, what procedures past, or what tests are needed to monitor its condition. Patients whose doctors do not have access to complete information during follow-up visits may be more likely to end up in the emergency room or be hospitalized again. (Goes the same for patients with scheduled follow-up visits at all.)
[Search Top Doctor near you.]
A study published Monday in the Annals of Internal Medicine seems to confirm these fears. Representative sample of Medicare patients to hospitals nationally between 2001 and 2006, those who were cared for by hospitalists have slightly shorter average hospital stays and hospital bills slightly lower than those cared for by primary care physicians. However, in 30 days after discharge, the hospitalist patients were more likely to be readmitted or land in the emergency room. One possible explanation: poor communication, as hospitalist patients were significantly less likely to follow with their primary care physicians after discharge.
To improve the quality of "care transitions" between hospitalists and family physicians, some health systems have designed programs to ensure patients get the recommended follow-up care. Two studies published last week in Archives of Internal Medicine evaluated two such programs. In one study, seniors who'd been hospitalized for heart failure at Baylor Medical Center Garland, Texas received several home visits by specially trained nurses between three days and three months after discharge. Those enrolled in the nurse visit program were only half as likely as patients who have heart failure to be readmitted within 30 days. In another study, patients at six hospitals were assigned coaches Rhode Island health (nurses or social workers) who visited them once in hospital, once at home, and telephoned them twice to encourage follow up with care physicians primary concern and ask about any signs or symptoms. Patients in the program were nearly 40 percent less likely to be readmitted within 30 days than patients who received no training of health.
[A Painless Guide to Your Hospital Stay Navigation]
Because it is impossible to predict whether you or a loved one will need to be hospitalized, it is important to understand your doctor's policies for patients who require hospitalization. You can start by asking these four questions:
Do doctors practice personally care for hospital patients, or do they rely on hospitalists?
If you live in a metropolitan area with multiple hospitals to choose from, at the hospital with your doctor prefer?
If you are considered a hospitalist, what protocols are in place to ensure timely communication between the hospital and the doctor's office follow your plans?
Are you eligible for any programs that help patients with care transitions?
Because of changes in medicine, it is unlikely that we will get back to the "old days" when the same doctors were responsible for caring for their patients both in and outside the hospital. Consequently, patients need to be proactive to make sure you receive the best after the hospital. That hospital is always stressful, but knowing that your follow up care will not fall through the cracks can give you peace of mind.
Doctors do the best they can to keep patients healthy and out of hospital. Sometimes, though, hospitalization is needed despite the best care possible. At first I joined private practice after training of residence, my colleagues and I have admitted patients in a local hospital and took turns caring for those who needed residential care. This system ensured Wed have easy access to their medical records before and often know them on a personal level. Arranging appointments office after discharge was almost never a problem, and we were guaranteed an understanding of what happened to our patients in the hospital.
That's all changed. The way patients receive hospital care has changed radically in the last 15 years. Many primary care physicians, pressure to take on more patients and exhausted from too many nights on call, stopped seeing their patients through a hospital stay. Instead, they now rely on "hospitalists," a relatively new breed of specialists to exclusive responsibility to care for patients in hospital.
[Preparing for Your Hospital Stay]
There are potential advantages to be treated by a hospitalist rather than a family doctor. Because hospitalists spend their time on the wards rather than trying to juggle obligations to patients in hospital and office, they're usually easier to reach with questions or concerns. Also, hospitalists may be more up-to-date on the latest medical research from residential treatment. These advantages should theoretically translate into better care and shorter stays for hospital patients. And they do, according to a 2007 study published in the New England Journal of Medicine, researchers found that patients cared for by hospitalists had shorter stays indeed hospital and medical costs lower than those cared for by primary care physicians.
But as hospitalists are replacing family doctors on hospital wards, concern is mounting that poor communication between the hospital and doctors office can lead to worse health outcomes after discharge. I personally know the frustration of seeing patients in office after recent hospital did not receive critical information about what medication changes were made, what procedures past, or what tests are needed to monitor its condition. Patients whose doctors do not have access to complete information during follow-up visits may be more likely to end up in the emergency room or be hospitalized again. (Goes the same for patients with scheduled follow-up visits at all.)
[Search Top Doctor near you.]
A study published Monday in the Annals of Internal Medicine seems to confirm these fears. Representative sample of Medicare patients to hospitals nationally between 2001 and 2006, those who were cared for by hospitalists have slightly shorter average hospital stays and hospital bills slightly lower than those cared for by primary care physicians. However, in 30 days after discharge, the hospitalist patients were more likely to be readmitted or land in the emergency room. One possible explanation: poor communication, as hospitalist patients were significantly less likely to follow with their primary care physicians after discharge.
To improve the quality of "care transitions" between hospitalists and family physicians, some health systems have designed programs to ensure patients get the recommended follow-up care. Two studies published last week in Archives of Internal Medicine evaluated two such programs. In one study, seniors who'd been hospitalized for heart failure at Baylor Medical Center Garland, Texas received several home visits by specially trained nurses between three days and three months after discharge. Those enrolled in the nurse visit program were only half as likely as patients who have heart failure to be readmitted within 30 days. In another study, patients at six hospitals were assigned coaches Rhode Island health (nurses or social workers) who visited them once in hospital, once at home, and telephoned them twice to encourage follow up with care physicians primary concern and ask about any signs or symptoms. Patients in the program were nearly 40 percent less likely to be readmitted within 30 days than patients who received no training of health.
[A Painless Guide to Your Hospital Stay Navigation]
Because it is impossible to predict whether you or a loved one will need to be hospitalized, it is important to understand your doctor's policies for patients who require hospitalization. You can start by asking these four questions:
Do doctors practice personally care for hospital patients, or do they rely on hospitalists?
If you live in a metropolitan area with multiple hospitals to choose from, at the hospital with your doctor prefer?
If you are considered a hospitalist, what protocols are in place to ensure timely communication between the hospital and the doctor's office follow your plans?
Are you eligible for any programs that help patients with care transitions?
Because of changes in medicine, it is unlikely that we will get back to the "old days" when the same doctors were responsible for caring for their patients both in and outside the hospital. Consequently, patients need to be proactive to make sure you receive the best after the hospital. That hospital is always stressful, but knowing that your follow up care will not fall through the cracks can give you peace of mind.
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