According to the Society of Hospital Medicine, hospital medicine is a medical specialty dedicated to the delivery of comprehensive medical care to hospitalized patients.
Internists practicing hospital medicine are frequently called "hospitalists.
In this segment, Dr. Fari Kamalpour, DO, Director of the Hospitalist program at Corona Regional Medical Center, discusses the role of a hospitalist and why they are an important part of your care team if you have to be hospitalized.
Selected Podcast
Hospitalist Medicine: Part of Your Care Team
Featured Speaker:
Fari Kamalpour, DO
Fari Kamalpour, DO is the Director of the Hospitalist program and a member of the medical staff at Corona Regional Medical Center. Transcription:
Melanie Cole (Host): According to the Society of Hospital Medicine, hospital medicine is a medical specialty dedicated to delivery of comprehensive medical care to hospitalized patients. Internists practicing hospital medicine are frequently called hospitalists. My guest today is Dr. Fari Kamalpour. She's the medical director of the Hospitalist's Program and a member of the medical staff at Corona Regional Medical Center. Welcome to the show, Dr. Kamalpour. So, let's start with what is a hospitalist? What is your training like? What do you do for the patient?
Dr. Fari Kamalpour (Guest): Good morning. My training, like most doctors and hospitalists is in internal medicine. Majority of the hospitalists in the United States are internal medicine trained physician. Obviously, we have some family medicine physicians who actually perform as the hospitalists plus some mid-level practitioners like nurse practitioners or physician’s assistant.
Melanie: So, how did this come about? Tell us a little bit about the history of hospital medicine.
Dr. Kamalpour: Well, the history goes back for at least 20 plus years. With the expansion of chronic diseases and the complexity of the care developed most of the internal medicine physicians, who were monitoring their patients in the community were not able to perform in terms of the time constraints and the new advances in hospital management of the patient in the hospital. So, the specialty was born to coordinate the care for the complicated patients that come into the hospital and their primary care physician is either unable, time-wise, or not available in the community to take care of the patient in the same hospital. The hospitalists came around 1995, the first company with a large group of hospitalists was established, but now we have numerous companies across the country with employed or independent practitioners that work with the hospital to provide the care.
Melanie: Okay, so what an interesting, you know, development because this is really a growing population of internists that are becoming hospitalists. So, Dr. Kamalpour tell us what you do exactly for the patient. How do you work with the nurses and the on-staff people at the hospital and the families and where is their regular physician in this picture?
Dr. Kamalpour: Well, our job, like any other hospitalist across the country, it starts when the patient is being admitted from the emergency department. We're going to be the sole physician responsible as the primary attending physician for the patient. Our job is to coordinate the care during the hospitalization with other specialists that are helping out with the management of the care. Also, coordinate the care with the ancillary service with the tests and everything that needs to be done. We do diagnosis, treatment, and procedures on the scope of our practice plus we coordinate and collaborate with other healthcare providers in the team. Majority -- I mean if the hospitalist is on the case -- the primary care physician would not be seeing the patient. Our job will be to safely transition the care after discharge to the primary care physician.
Melanie: Okay, so in the hospital itself, then once they're out, then it goes back to the primary care physician. What are you able to do? Can you recommend tests, do you speak with the family about outcomes? Can you even help them set up appointments with other doctors if they've been told they have cancer or some chronic lung condition? Can you help them set up those appointments?
Dr. Kamalpour: Absolutely. Absolutely. Our job is very comprehensive. After we make the diagnosis, if it's a new diagnosis, we set up the follow-up treatment as an outpatient. Obviously, any treatment or further testing that needs to be done as on inpatient basis will be performed before the patient leaves, but the follow-ups will be arranged prior to discharge. Also, with the families and the social aspect of the care we're going to be the direct person to contact the family and usually with our patients we have daily meeting if the family's available. We coordinate the care with our case management if the patient needs a transitional care after discharge, going to rehab, or long-term acute or even transfer to tertiary center because in my hospital -- we are a community hospital, and a lot of hospitals in the country have to occasionally send the patient to a higher level of care. For all those, we are going to be responsible -- we are going to be the one who calls it in, makes a decision, and recommends.
Melanie: And what about once they are released and helping them settle into one of those facilities you mentioned or even home? Can you help the families set up home health care or any equipment needed? Can you advise them on what it is that they're going to need if they are taking their loved one home?
Dr. Kamalpour: Absolutely. At the time of discharge, usually there is an evaluation in terms of the physical ability of the patient or any speech therapies that they need physical therapy, occupational therapy that they need, and we are going to recommend -- a home-health agency will be decided before the discharge, but the family gets the choice of different companies available in the community, and they choose their own company, and they usually are met by the agency's representative within 24 hours at home. If the patient goes to a skilled nursing facility, either the primary care physician will take care of them, or the medical director of the facility will take care of them while the patient is still there. If the patient is going to long-term acute rehab, usually, it's the medical director, or based on availability, the primary care physician may choose to monitor the patient during those courses of rehabilitation. We also help our patients with end of life decision making. If they need comfort care arranged for them in terms of hospice, that is going to be arranged in the hospital, and the patient either goes home with hospice, or if they need to go to a setting -- if skilled nursing is available -- it's going to be arranged.
Melanie: What about if they have to have surgery, Dr. Kamalpour, where do you fit into that picture, then? Are you with them before and then after and the surgeon takes over for the procedure, whatever they may need? How does that fit into this timeline?
Dr. Kamalpour: Actually, in our hospital, our surgical cases that come through the emergency department are admitted to internal medicine and that fits a lot of hospitals across the country. If the patient is admitted to us, we're going to be, obviously, from the very beginning, to the end. The hospitalist will be responsible for admitting, arranging for the surgery, obtaining medical clearance for patient if they are at some level of risk for a surgery, and also coordinating the surgical procedure with the surgeon. Post-op care also is going to be on hospitalists until the patient gets cleared by the surgeon. That's when, if the patient is medically stable, can be discharged home -- so, from very beginning until the end. There are other aspects of involvement of a hospitalist in the surgical cases is that the patient comes in as an outpatient scheduled surgical procedure which occurs all across the country, and the majority of these cases we are being in the team as a form of a consult for the surgery. Basically, the surgeon would be the primary, and we act as the consult in terms of medical management of the patient. We clear the patient medically at the time that the patient is appropriate to go home, and the surgeon is actually the one who discharges the patient.
Melanie: Wow, so you really have a very comprehensive, multi-disciplinary job for the patients that are in the hospital. So, wrap it up for us, Dr. Kamalpour and give your best advice or your best information, what you like people to know about what you do for a living, and why they should come to Corona Regional Medical Center for their care.
Dr. Kamalpour: Well, what I do for a living is to be with my patient at the worst time of their life, being in a hospital -- in a nutshell -- but in general, what I do is I will fill in the transitional gap in their care until they get back to their primary care physician, and even if they don't have a primary care physician -- let's say the patients were new to the area and their first encounter with a medical profession in the community is the hospital. We help them to find a primary care physician at discharge. While they are here, they're going to be directly under my care. Obviously, there is a huge collaboration between me and my colleagues, the different specialties, and also other services in the hospital to make sure that their stay in the hospital is safe, efficient, and hopefully with the best outcome. The other aspect of my job would be involved in the hospital system improvement. As a hospitalist, I participate in many programs that are aimed at quality improvement, patient safety, medication safety and all those things that is not going to be mentioned at the patient bedside, but definitely impacts the patient's care on a daily basis.
Melanie: And tell us about your team at Corona Regional Medical Center.
Dr. Kamalpour: Well, my team, like any other team in the country we have providers that are here, usually from 7am to 7pm, and I am blessed with having four very good colleagues that work with me as a full-time basis. I also have some providers that work with us as part-time basis. They are all physicians. Some of them have been in this hospital for a longer time than others. I, myself, have been here for about five years. I've had the pleasure of taking care of the people in the Corona community. I have been involved in improvement projects in the hospital. They are looking forward to serve the community for many years to come.
Melanie: Thank you so much for being with us today. You're listening to Corona Regional Radio with Corona Regional Medical Center. For more information, you can go to coronaregional.com. That's coronaregional.com. Physicians are independent practitioners who are not employees or agents of Corona Regional Medical Center. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks so much for listening.
Melanie Cole (Host): According to the Society of Hospital Medicine, hospital medicine is a medical specialty dedicated to delivery of comprehensive medical care to hospitalized patients. Internists practicing hospital medicine are frequently called hospitalists. My guest today is Dr. Fari Kamalpour. She's the medical director of the Hospitalist's Program and a member of the medical staff at Corona Regional Medical Center. Welcome to the show, Dr. Kamalpour. So, let's start with what is a hospitalist? What is your training like? What do you do for the patient?
Dr. Fari Kamalpour (Guest): Good morning. My training, like most doctors and hospitalists is in internal medicine. Majority of the hospitalists in the United States are internal medicine trained physician. Obviously, we have some family medicine physicians who actually perform as the hospitalists plus some mid-level practitioners like nurse practitioners or physician’s assistant.
Melanie: So, how did this come about? Tell us a little bit about the history of hospital medicine.
Dr. Kamalpour: Well, the history goes back for at least 20 plus years. With the expansion of chronic diseases and the complexity of the care developed most of the internal medicine physicians, who were monitoring their patients in the community were not able to perform in terms of the time constraints and the new advances in hospital management of the patient in the hospital. So, the specialty was born to coordinate the care for the complicated patients that come into the hospital and their primary care physician is either unable, time-wise, or not available in the community to take care of the patient in the same hospital. The hospitalists came around 1995, the first company with a large group of hospitalists was established, but now we have numerous companies across the country with employed or independent practitioners that work with the hospital to provide the care.
Melanie: Okay, so what an interesting, you know, development because this is really a growing population of internists that are becoming hospitalists. So, Dr. Kamalpour tell us what you do exactly for the patient. How do you work with the nurses and the on-staff people at the hospital and the families and where is their regular physician in this picture?
Dr. Kamalpour: Well, our job, like any other hospitalist across the country, it starts when the patient is being admitted from the emergency department. We're going to be the sole physician responsible as the primary attending physician for the patient. Our job is to coordinate the care during the hospitalization with other specialists that are helping out with the management of the care. Also, coordinate the care with the ancillary service with the tests and everything that needs to be done. We do diagnosis, treatment, and procedures on the scope of our practice plus we coordinate and collaborate with other healthcare providers in the team. Majority -- I mean if the hospitalist is on the case -- the primary care physician would not be seeing the patient. Our job will be to safely transition the care after discharge to the primary care physician.
Melanie: Okay, so in the hospital itself, then once they're out, then it goes back to the primary care physician. What are you able to do? Can you recommend tests, do you speak with the family about outcomes? Can you even help them set up appointments with other doctors if they've been told they have cancer or some chronic lung condition? Can you help them set up those appointments?
Dr. Kamalpour: Absolutely. Absolutely. Our job is very comprehensive. After we make the diagnosis, if it's a new diagnosis, we set up the follow-up treatment as an outpatient. Obviously, any treatment or further testing that needs to be done as on inpatient basis will be performed before the patient leaves, but the follow-ups will be arranged prior to discharge. Also, with the families and the social aspect of the care we're going to be the direct person to contact the family and usually with our patients we have daily meeting if the family's available. We coordinate the care with our case management if the patient needs a transitional care after discharge, going to rehab, or long-term acute or even transfer to tertiary center because in my hospital -- we are a community hospital, and a lot of hospitals in the country have to occasionally send the patient to a higher level of care. For all those, we are going to be responsible -- we are going to be the one who calls it in, makes a decision, and recommends.
Melanie: And what about once they are released and helping them settle into one of those facilities you mentioned or even home? Can you help the families set up home health care or any equipment needed? Can you advise them on what it is that they're going to need if they are taking their loved one home?
Dr. Kamalpour: Absolutely. At the time of discharge, usually there is an evaluation in terms of the physical ability of the patient or any speech therapies that they need physical therapy, occupational therapy that they need, and we are going to recommend -- a home-health agency will be decided before the discharge, but the family gets the choice of different companies available in the community, and they choose their own company, and they usually are met by the agency's representative within 24 hours at home. If the patient goes to a skilled nursing facility, either the primary care physician will take care of them, or the medical director of the facility will take care of them while the patient is still there. If the patient is going to long-term acute rehab, usually, it's the medical director, or based on availability, the primary care physician may choose to monitor the patient during those courses of rehabilitation. We also help our patients with end of life decision making. If they need comfort care arranged for them in terms of hospice, that is going to be arranged in the hospital, and the patient either goes home with hospice, or if they need to go to a setting -- if skilled nursing is available -- it's going to be arranged.
Melanie: What about if they have to have surgery, Dr. Kamalpour, where do you fit into that picture, then? Are you with them before and then after and the surgeon takes over for the procedure, whatever they may need? How does that fit into this timeline?
Dr. Kamalpour: Actually, in our hospital, our surgical cases that come through the emergency department are admitted to internal medicine and that fits a lot of hospitals across the country. If the patient is admitted to us, we're going to be, obviously, from the very beginning, to the end. The hospitalist will be responsible for admitting, arranging for the surgery, obtaining medical clearance for patient if they are at some level of risk for a surgery, and also coordinating the surgical procedure with the surgeon. Post-op care also is going to be on hospitalists until the patient gets cleared by the surgeon. That's when, if the patient is medically stable, can be discharged home -- so, from very beginning until the end. There are other aspects of involvement of a hospitalist in the surgical cases is that the patient comes in as an outpatient scheduled surgical procedure which occurs all across the country, and the majority of these cases we are being in the team as a form of a consult for the surgery. Basically, the surgeon would be the primary, and we act as the consult in terms of medical management of the patient. We clear the patient medically at the time that the patient is appropriate to go home, and the surgeon is actually the one who discharges the patient.
Melanie: Wow, so you really have a very comprehensive, multi-disciplinary job for the patients that are in the hospital. So, wrap it up for us, Dr. Kamalpour and give your best advice or your best information, what you like people to know about what you do for a living, and why they should come to Corona Regional Medical Center for their care.
Dr. Kamalpour: Well, what I do for a living is to be with my patient at the worst time of their life, being in a hospital -- in a nutshell -- but in general, what I do is I will fill in the transitional gap in their care until they get back to their primary care physician, and even if they don't have a primary care physician -- let's say the patients were new to the area and their first encounter with a medical profession in the community is the hospital. We help them to find a primary care physician at discharge. While they are here, they're going to be directly under my care. Obviously, there is a huge collaboration between me and my colleagues, the different specialties, and also other services in the hospital to make sure that their stay in the hospital is safe, efficient, and hopefully with the best outcome. The other aspect of my job would be involved in the hospital system improvement. As a hospitalist, I participate in many programs that are aimed at quality improvement, patient safety, medication safety and all those things that is not going to be mentioned at the patient bedside, but definitely impacts the patient's care on a daily basis.
Melanie: And tell us about your team at Corona Regional Medical Center.
Dr. Kamalpour: Well, my team, like any other team in the country we have providers that are here, usually from 7am to 7pm, and I am blessed with having four very good colleagues that work with me as a full-time basis. I also have some providers that work with us as part-time basis. They are all physicians. Some of them have been in this hospital for a longer time than others. I, myself, have been here for about five years. I've had the pleasure of taking care of the people in the Corona community. I have been involved in improvement projects in the hospital. They are looking forward to serve the community for many years to come.
Melanie: Thank you so much for being with us today. You're listening to Corona Regional Radio with Corona Regional Medical Center. For more information, you can go to coronaregional.com. That's coronaregional.com. Physicians are independent practitioners who are not employees or agents of Corona Regional Medical Center. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks so much for listening.