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Carl Maronich (Host): Today we are joined by Dr. Veena Bhamre. Dr. Bhamre is a pediatric hospitalist with the University of Chicago Medicine Comer Children’s Hospital working at Riverside and we will talk more about that partnership. She completed her residency at the University of Illinois College of Medicine in Peoria and is Board Certified in Pediatrics. She’s a Fellow in the American Academy of Pediatrics and serves, most importantly to us as the site director for the Pediatric Hospitalist Program at Riverside. Doctor, welcome to the podcast.

Veena Bhamre, MD (Guest): Thank you, thank you for having me.

Carl: We appreciate you joining us. A pediatric hospitalist is what you are, and we are going to talk more about that, but first, let’s hear a little bit about your background. Where did you grow up?

Dr. Bhamre: I grew up in California in the Bay Area close to San Francisco.

Carl: So, are you a Forty Niner’s fan, Giant’s fan?

Dr. Bhamre: Forty Niner’s fan.

Carl: Okay, we can forgive that. Do you have any baseball loyalties?

Dr. Bhamre: No baseball loyalties.

Carl: Okay, well then, we can make a Cub fan out of you, perhaps now that you are in the Midwest.

Dr. Bhamre: Yes, definitely.

Carl: Very good. Well a pediatric hospitalist, let’s first start with talking a little bit about what that is. So, tell the folks what a pediatric hospitalist does.

Dr. Bhamre: So, a pediatric hospitalist is a pediatrician except our role is just to serve babies and children that are in the hospital only.

Carl: So, just hospital-based care is what you provide to those folks that are here. And how is it you came to be in pediatric medicine? What was it about that, that drew you to it?

Dr. Bhamre: During medical school, it was the one rotation I had where I was just the happiest at the end of my day, after seeing all the kids, no matter how crazy the day was, what was going on; there was always at least one kid that smiled or laughed or made your day really worthwhile. So, I figured if I was going to do something for the next forty years, I should have that at the end of each day.

Carl: Yeah, that’s a wonderful philosophy and a way to get into it. And certainly, pediatrics is an emotional specialty. I mean you are dealing with parents, oftentimes kids are not able to tell you where it hurts or what the problem is, and you are dealing with parents as well, so a very emotional time but as you are saying, I’m sure very satisfying oftentimes, as well.

Dr. Bhamre: Definitely very satisfying.

Carl: And so, a pediatrician and a hospitalist. Now let’s talk a little bit about what a hospitalist is again.

Dr. Bhamre: So, a hospitalist takes care of patients that are in the hospital. It is anyone that is admitted to the hospital or needs to get their care in a hospital-based setting. So, for a pediatrician, mainly, what we do is we take care of newborns in the nursery, we take care of kids that are admitted from their doctor’s office to the inpatient floor and we also do a couple of other things too. We go to deliveries, so babies that might need some extra help after they are born, we are there to kind of help them out and in the ER, we kind of serve as a base for help in pediatric care. So, the ER physicians are well-versed in pediatrics, but if they ever have like a little bit more in-depth question or want us to take a look at a child that has come through the ER and we are there available to help them out with that.

Carl: So, from the pediatric inpatient unit to the nursery to the ER, you are all over the hospital.

Dr. Bhamre: All over the hospital, yes.

Carl: Let’s talk more about the hospitalist model. That’s something that is relatively new within the last decade it’s really become more popular and I think some people who fortunately don’t go to the doctor a lot may not understand that the doctor they see in their office, their kind of family doctor, may not be seeing them in the hospital as well. That’s kind of a shift in the dynamic of the patient provider relationship. Do you encounter patients that are surprised at that model or weren’t aware of it and have any concerns about that?

Dr. Bhamre: We do sometimes see that because patients are used to seeing their doctor and they kind of don’t want to have a new doctor that they explain everything to again, and so, they want to see their own doctor. The benefit of actually us being in the hospital and different from their own doctor; their doctor one has the time to kind of focus on their patients in the outpatient setting and deliver the best care to those patients in that time and then we, because we are just in the inpatient setting, can focus on the patients only in the hospital which is really nice. So, that kind of each side can focus truly on what they are doing and, in that way, deliver almost better care that way.

Carl: Sure, well I would guess as the inpatient provider, you are seeing that patient probably more often than a physician who also has an office practice and has to get to the hospital is able to see them.

Dr. Bhamre: Definitely. I think a lot of outpatient providers in order to see patients in the hospital have to come before they have clinic or during their lunchbreak or even after they are done and to that is definitely really hard when you are trying to see all you patients in the clinic and do a really good job in taking care of them. So, it is really helpful that we are in the hospital and we can check on them throughout the day, throughout the night even as well, and address any issues that come up.

Carl: Yeah. As a hospitalist, again, you are here, you are able to interact with parents, which as a pediatrician, that’s a big part of the practice. Do you see them quickly, kind of embracing the hospitalist idea and understanding that you are there really all the time for them in the hospital?

Dr. Bhamre: I think maybe initially, if they are wary about it, that slowly wanes after they notice how much time we are spending with them in the hospital and then the ability for us to come back and visit them often, and I think after a couple of times of doing that; they slowly I think any hesitancy usually goes away. Because they realize like oh, you are right here, if I need to talk to you it’s a matter of maybe twenty minutes versus a few hours.

Carl: Right sure, a benefit there. Let’s talk a little about the relationship between University of Chicago Comer Children’s Hospital which is a mouthful, it’s a lot to say and Riverside. We have had the partnership a couple of years now and you are Comer’s pediatrician, employed by them, but stationed, I will say, at Riverside. Talk a little bit about how that relationship has gone and explain a little bit more about it.

Dr. Bhamre: So, the relationship is going really well. The advantage to us being part of Comer is that we have the whole backing of that system to kind of help us out and help bring quality pediatric care here. So, in the community, we don’t have a lot of pediatric subspecialists or pediatric specialty providers, so by having Comer, when we are on and we are in the hospital, we can easily give them a call, we can talk to them over the phone, they can help us guide our management for some of those like a little bit more complex cases and also if a child is very sick or needs something done at kind of a higher level, that’s kind of a good gateway to have that happen and it’s a lot easier and hopefully more seamless for the family too.

Carl: Yeah. And the pediatric hospitalists are here 24-7, around the clock they are here. So as we talked about from the delivery room to the emergency room, they are here to provide help should it be needed at any time.

Dr. Bhamre: At any time, so we stay in-house 24-7, so if something happens at 3 o’clock in the morning, we are right there, nobody has to come in from home or anything like that. So, if there’s every any emergencies and that can be in the delivery room where that happens the most commonly, but even on the inpatient floor, if a child gets sicker overnight, we are there to kind of take a look at them, do what we need to immediately and kind of go from there.

Carl: Yeah, that has to be reassuring to parents to know if their child is in the hospital and something happens, you are right there with that expert care.

Dr. Bhamre: Yeah, I think it brings a lot of peace of mind when they realize that we are there and especially for those kids that are on the more sick side, to know that we can come and see them more often during the day and we are there even overnight to do anything that is needed.

Carl: Yeah, you probably have some of them say can you be my doctor all the time?

Dr. Bhamre: We do get that once in a while, definitely and we always have to say, sorry, we can’t see you when you leave the hospital, but we make sure that we communicate really well with their doctors so that that transition is also seamless as well.

Carl: And you wouldn’t say we hope we never see you again, but you hope they don’t come back often.

Dr. Bhamre: Exactly. We hope that they stay healthy and so they don’t have to stay in the hospital.

Carl: Yes. Talk a little bit about the relationship between you and the pediatrician, their family doctor. I would guess there has to be a lot of communication and is a lot of communication back and forth.

Dr. Bhamre: There is a lot of communication. So, one of the advantages obviously, is we have great electronic medical records so that makes communication a lot easier. So, the doctors that have access to the system will have access to their entire records. So, they will be able to see all our notes, everything that we have done for them here. Even if their doctor doesn’t have access to that, we call the doctor at the end of their stay and we let them know what we have done for them in the hospital, what interventions we may have done, what follow-ups we may have provided and then we will give them a copy of the discharge summary.

Carl: Yeah, so they know.

Dr. Bhamre: And so, they know, and even doctors, so we have partnership with a lot of the community doctors out here and so if they want to have their kids come into the hospital, they will give us a call and we have a conversation even before the child comes to the hospital. So, that communication is already there before the child sees us at all.

Carl: When you were going through medical school, did the hospitalist model, was that something that attracted you? Did you think about it even back then or is that something that kind of came up later as you were getting into the practice of medicine?

Dr. Bhamre: In medical school, I actually didn’t think of the hospitalist model very much and in pediatrics, it’s a relatively newer model. Hospitalists have been around for adults for a very long time, but for pediatrics, I would say it’s only become much more popular in the last ten to fifteen years. when I was in residency, though, I had a lot of great mentors and a lot of great role models that were hospitalists and I ended up really enjoying it. And so, that’s where I think I decided and kind of had more of a passion for being a hospitalist and wanting to go a long that route in my career.

Carl: Yeah, well we are fortunate and glad you did. And as the director of the hospitalist program here at Riverside, you have a team of hospitalists that are here and assigned to Riverside, so it is the same pediatric hospitalists that are coming back and serving the patients here.

Dr. Bhamre: Yes, so our group in general, consists of about 12 pediatricians and the majority of those come to Riverside on a regular basis.

Carl: Yeah, well, that’s great to have that consistent care. Well doctor, I think we have covered everything. Is there anything else you want to add or mention with regard to the practice and the practice here at Riverside?

Dr. Bhamre: I don’t think so. I think we are really happy and we are really grateful that we are able to serve the community here and I know we really enjoy coming and being able to take care of the children out here and help out the doctors and provide good pediatric care for the community.

Carl: Yeah, be reassuring to the parents so that they know their kids are in great hands.

Dr. Bhamre: Yes, they are.

Carl: Well thank you very much Dr. Veena Bhamre, Pediatric Hospitalist at Riverside. Thanks so much for joining us.

Dr. Bhamre: Thank you.