What is a hospitalist?

Observer Co-owner Lisa Feorenzo’s step-mother wasn’t feeling well two weeks ago, so after a brief call with her general practitioner (GP from here on), the doctor told her to get to the nearest emergency room as quickly as she could. Since Nancy lives in Toms River, it was only natural for her to go to Community Medical Center, also in Toms River.

Without getting too much into details about why Nancy was in hospital, it’s what happened shortly after she was admitted that left her, Lisa and a lot of others absolutely perplexed.

“They told us she couldn’t see her GP and would have to, instead, see a ‘hospitalist,’” Feorenzo said. “None of us had any idea what a hospitalist even is. And it makes absolutely no sense a patient, whose personal doctor knows the most about their medical history, cannot present themselves in this hospital, even if they had privileges to do so in the past.”

Again, perplexed, Feorenzo told yours truly about the ordeal.

So I spoke with my own doctor.

He told me in 2019, there was a statewide policy implemented that barred physicians from visiting their hospitalized patients. When the COVID-19 pandemic hit a year later, the policy remained in place — no visits. Then in 2021, the decision as to whether a physician may visit a patient in hospital was turned over to local medical ownerships.

Where the authority for any of this comes form, we’re still unsure. But Feorenzo got somewhat of an explanation about it from a patient advocate at Community.

“They told us this was all a result of decisions made by the insurance companies — the insurance industry,” Feorenzo recalls of the conversation.

Still dissatisfied, she picked up the phone and called her own insurer, Horizon Blue Cross-Blue Shield of New Jersey. She explained to someone in a management position what she had been told by the hospital in Toms River — and that the fault was being laid at the hands of the insurance industry.

“The gentleman who I spoke with — who was great, by the way — said he had never heard of such a thing before,” Feorenzo said of her chat with the employee. “He put me on hold a few times, came back to confirm what I was telling him, and he started asking around. No one in his office could confirm what we had been told. So at this point, there is no doubt in my mind we were getting bad information. Or were we? If a major New Jersey medical insurance company had no idea what I was talking about, it stands to reason this is likely not a policy enacted by insurance companies as I had been led to believe by the advocate.”

Whats the deal?

Since there was so much conflicting information floating around — and because this could likely affect any and all people who ever have to go to an ER or hospital for any reason — we reached to a few hospital contacts. Unfortunately, for a variety of reasons, no one would go on the record. Others completely ignored our request for information about the role of the hospitalist.

Still, here’s what we learned.

“Hospitalist” is a term and practice that, in the greater scheme of things, is relatively new. The term, itself, was coined circa 1996. Hospitalists are staff members who are employed to work by hospitals or chains of hospitals. They work regular shifts and their role is similar to that of a GP. Where they are used, there is generally a hospitalist — or more than one — on duty 24 hours a day.

They’re supposed to coordinate a patient’s overall care when they’re admitted. And, instead of GPs having to travel to different hospitals to visit their patients, the hospitalist should act as a liaison between the GP, the hospital and specialist doctors who might be involved in a person’s in-patient care.

In theory, the hospitalist should be in regular contact with a patient’s GP, we’re told. And most GPs set aside a certain portion of each working day to conduct business with hospitalists on the telephone. What’s not fully clear, just yet, is whose responsibility it is to initiate the contact with the other.

Is it the GP who calls the hospitalist or vice-versa? Or is it a mixture of both?

In the case of Feorenzo’s step-mother, her GP was aware of what happened to her whilst she was admitted, but it wasn’t clear who made the phone calls. Or who should make the calls.

So why is all of this necessary?

One of the hospital employees we did speak with explained it fairly succinctly.

“If a physician has patients in more than one hospital, it is really not easy for them to travel to all the different locations,” the employee, whose name we will not use, because they are not authorized to speak on the matter, said. “Let’s say a doctor has a patient in a hospital in Essex County, Bergen County and Hudson County. That’s a lot of ground for one doctor to cover. The hospitalist’s position is extraordinary in that she or he can coordinate a patient’s care right from the hospital in conjunction with a GP. There’s no need to travel and in theory, every doctor with hospitalized patients will spend part of the day working the phones. It’s really a win-win situation for overburdened physicians, for the patients and for the hospitals.”

Editors note: Well share more information about this process once it becomes available. Be sure to look for updates both online at www.theobserver.com and in print in The Observer.

 

 

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Kevin A. Canessa Jr. is the editor of and broadcaster at The Observer, a place where he has served on and off since 2006. He is responsible for the editorial content of the newspaper and website, the production of the e-Newspaper, writing several stories per week (including the weekly editorial), conducting live broadcasts on Facebook Live, including a weekly recap of the news — and much more behind the scenes. Between 2006 and 2008, he introduced the newspaper to its first-ever blog — which included podcasts, audio and video. Originally from Jersey City, Kevin lived in Kearny until 2004, lived in Port St. Lucie. Florida, for four years until February 2016 and in March of that year, he moved back to West Hudson to return to The Observer full time. Click Here to send Kevin an email.