Hospitalists provide invaluable roles

To the contrary, these positions aren’t ‘cushy’

I am writing in response to your series of articles regarding the shortage of primary care physicians in our area.

I am speaking on behalf of the Lexington Hospitalist group at UPMC Altoona. We are addressing a few statements made by the primary care providers (PCPs) featured in your articles.

While most of your readers are familiar with hospital medicine specialists (hospitalists), to some it may be a new concept. Hospitalists have become a standard in U.S. hospitals. There are 50,000 hospitalists in the U.S.

The specialty was first introduced in 1996, and 80 percent of hospitals employ them. We are trained as primary care physicians (internists or family practice physicians) and are board certified in our respective specialties.

The American Board of Internal Medicine now offers a concentration in recertification in hospital medicine. Experts agree hospitalists improve of quality of care by avoiding hospital infections and complications, decreasing length of stay and streamlining discharges thereby reducing costs — all of which contribute to improved health care outcomes.

One of the physicians in the articles pointed out that UPMC does not support primary care physicians since it employs 25 of us on the hospital staff, and we would be better utilized in the community PCP offices.

On the contrary: Our presence on the hospital staff enhances the recruitment of PCPs to the community. Many PCPs want to devote their time to outpatient medicine exclusively and appreciate hospitalists’ expertise in caring for their hospitalized patients.

Because we are in the hospital 24/7, your PCP does not need to alter his/her schedule in the office; he/she does not need to come in the middle of the night or disrupt his/her day by rounding before office hours (sometimes delaying morning appointments); at lunch (delaying afternoon appointments) or rounding after hours (disrupting family life).

He/she does not have to come in on weekends or holidays, either, overall improving quality of life. Therefore, your PCP is available to see more patients, keep his/her schedule on time without emergency interruptions, get quality time with family and be well-rested and generally happier.

As a former PCP in the community who did it all, I speak from experience. That is why the majority of PCPs in the area choose to have our group care for their hospitalized patients. Our patients often have multiple complex medical problems that require specialized care.

Some of your PCPs have not treated hospital patients for more than 10 years. Do you really want that doctor to treat you or your loved one in the hospital today? Conversely, some of us have not been in the office for 10 years, and we could not easily return to office medicine.

In addition, we have many patients who do not have a PCP or are transferred from outlying community hospitals and their PCP is not local. Previously, these patients would be assigned to the community PCP’s who would have to assume their care. Currently, we take the majority (90 percent) of these patients on the hospitalist service.

Another physician stated that we chose “a cushy job such as a hospitalist.”

We work 12 hour-plus days; each of us work every other weekend and half of all holidays; both UPMC Altoona and UPMC Bedford Memorial are covered by our group 24/7.

We respond to inpatient emergencies, and we are present in the ER the majority of the day in order to see new admissions quickly and efficiently. If a hospital physician is unable to come to work, we have a backup doctor who can cover at a moment’s notice.

We coordinate care with specialists; we transfer patients to tertiary care hospitals when our facility cannot accommodate a patient’s level of care. We have a very stressful job and deal with acute and often, life-threatening illness.

We get to know patients and families at their most vulnerable. We hold hands with your sick mom/dad/spouse during critical and emotional times. We do not go home until our job is done.

We love our job and we feel as though we are serving our community in a noble way.

Dr. Nancy Kenney is the vice chairwoman of the department of hospital medicine at UPMC Altoona.