Selected Podcast

Hospitalist Medicine

You're in the hospital and expecting a visit from your regular doctor.

Instead, you get a visit from a hospitalist.

Who are hospitalists and what do they do for you when you are hospitalized?

Dr. Evangeline Gutierrez discusses what hospitalist medicine is and the benefits of being cared for by a hospitalist.
Hospitalist Medicine
Featured Speaker:
Evangeline R. Gutierrez, MD
Evangeline R. Gutierrez, MD, FHM, is Director of Hospitalist Medicine at Morristown Medical Center in Morristown, New Jersey.

Before joining the Summit Medical Group Hospitalist Medicine team, Dr. Gutierrez practiced as a registered nurse. She was Medical Director of the Inpatient Medical Associates of Parsippany, for whom she practiced for more than 10 years at Overlook Medical Center. Dr. Gutierrez is a fellow of the Society of Hospitalist Medicine.

Organization: Summit Medical Group: Hospitalist Medicine
Transcription:
Hospitalist Medicine

Melanie Cole (Host): You're in the hospital and expecting a visit from your regular doctor, and instead you get a visit from a hospitalist. Who are they, and what do they do for you when you're hospitalized? My guest is Dr. Evangeline Gutierrez. She's board-certified in internal medicine and director of Hospitalist Medicine for Summit Medical Group in Morristown Medical Center. Welcome to the show, Dr. Gutierrez. Tell us exactly who are hospitalists. What do they do?

Dr. Evangeline Gutierrez (Guest): Hospitalists are internal medicine physicians who are board-certified and specialized in inpatient medicine. They are doctors who go to the hospital to visit patients on a regular basis every day, sometimes not just once a day, even twice a day to make sure that each patient receives the quality of care that they deserve.

Melanie: So what sets them apart from your regular physician?

Dr. Gutierrez: A hospitalist normally does not see patients in the outside world. We focus on patients who are admitted to the hospital from admission to discharge. What we do is we make sure that quality care is provided. We coordinate the care among the different consultants if needed be during the stay in the hospital. Patients are evaluated on a daily basis, and we help coordinate the discharge process that there will be good hand-off from the time of admission and when they leave the hospital back into their primary care physician.

Melanie: So what is the relationship between the primary care physician and the hospitalist?

Dr. Gutierrez: Basically, a hospitalist is the one who would provide the care in the hospital. The primary care physician, who stays in the office, communicates with the hospitalist, who is now in charge of the care of the patient while the patient is in the hospital.

Melanie: So the hospitalist is in charge of the patient while they're in the hospital. Is there a hierarchy there with the physicians?

Dr. Gutierrez: Well, the hospitalist is in charge while the patient is in the hospital who helps coordinate the medical care while you are in the hospital, and that is what we do.

Melanie: So what are some of the benefits of having a hospitalist versus having just your physician come on rounds or do what they normally or used to do?

Dr. Gutierrez: A hospitalist can help lessen the amount of time you'd stay in the hospital by coordinating your care. There is a lot of collaboration with the other existing physicians in the hospital and the necessary work up of your health while you are in the hospital.

Melanie: So when do you visit the patient, Dr. Gutierrez? You mentioned maybe a few times a day. And do you work with the family as well as the patient to explain and bridge the gap between some of the complicated medical information and what the patient really needs to know and understand about their treatment?

Dr. Gutierrez: Yes, we do that. What we do is we start our day early. The patient is seen from the time of admission. If once you are already admitted, on a daily basis, the hospitalist visits you in the hospital. Say for example, I see you in the morning. If your work up has been done during the day and I see that we could do some more stuff for you or maybe even send you home, we could even visit you again by the end of the day and send you out of the hospital as needed. And then what we do, we make sure we communicate with your primary care physician, give them a phone call, and whatever work up that we have done for you in the hospital, a summary is dictated and sent out to the primary care.

Melanie: What if another specialist is needed while they're in the hospital? How do you work that coordination? Is this with getting the physicians to come see the patient, getting visits set up and tests? It can be an awfully dizzying and confusing world when you're in the hospital with the tests and different specialists. How does that work?

Dr. Gutierrez: Based on our evaluation, if the patient needs a specialist while you are in the hospital, we make that coordination with them. We make that phone call, discuss your case with them, and make sure that the necessary work up is done. And while you are also in the hospital, we make sure that we communicate with the family members and discuss what the plans are on a daily basis.

Melanie: What is the multidisciplinary approach with the hospitalist? Are there others that you bring in, nutritionists, anything to help with the care of this person so that they get out of the hospital quicker? And then what do they expect when they do leave the hospital?

Dr. Gutierrez: That's an excellent question, actually, Melanie, because what we do from the time of admission, we plan the discharge right off the bat. We speak with the social worker, the case managers. If the patient has some home needs upon discharge, if they need to go to sub-acute rehab, we arrange all that for them. And then this discussion continues with the family members and the patients as to what they will be comfortable with in doing when they leave the hospital when they are stable enough to do so.

Melanie: Okay. So you can definitely bring in all the parties. And where the family is concerned, Dr. Gutierrez, you help them to understand what's going on with this patient if there are difficult decisions to be made. Do you help them with those decisions? Is that somebody else? You bring in a pastor, a counselor? Is that your job?

Dr. Gutierrez: Yes. That is also our job. We have to also coordinate the plan after leaving the hospital. Sometimes, unfortunately, if the health condition is towards the end of their lives, we also coordinate that with our palliative care team and discuss whether staying at home and not coming back to the hospital will be an option, or sometimes, sending them to a facility where they will be comfortable towards the end of life.

Melanie: So please tell us in the last two minutes or so, Dr. Gutierrez, what makes the hospitalist program at Summit Medical Group different than other programs out there?

Dr. Gutierrez: Summit Medical Group Hospitalist Program sets us apart from the other hospitalist programs out there in a few ways. One, we have electronic medical records that our hospitalists are able to view what's going on from the outside outpatient that we're able to see that once the patient is admitted. So there is continuity in terms of your medical records. Number two, when the patient is in the hospital, we make sure that there is communication with our primary care doctors and our consultants within the group. So then, within the family of Summit Medical Group, all the care that you get from the outside is continued while you are in the hospital. Number three, we make sure that our care managers are informed upon discharge. We send them notes through our electronic health records to tell them what needs to be followed up the moment you leave the hospital, as in if you need to see your doctor in two days, if you need blood work in a week. All these are communicated effectively to make sure that once you leave the hospital, this is all done, and then there won't be a gap once you are discharged. So this is really important for us that we keep the communication intact, so then there will be excellent and collaboration and coordination of your care.

Melanie:   Well, that certainly is what it's all about, Dr. Gutierrez, is that communication and the coordination of all the different aspects of medicine that make a hospitalist such a special practitioner of medicine today. Thank you so much for being with us. You're listening to SMG Radio. For more information, you can go to summitmedicalgroup.com. This is Melanie Cole. Thanks so much for listening.