Hospitalist physician care and medical malpractice

 

The attention of hospitalists is often divided. A Sugar Land, Texas hospitalist says that he sees 24+ patients a day.

 
January 1, 2018

As a Houston, Texas medical malpractice attorney, I have handled many cases arising from healthcare provided by hospital-based physicians called hospitalists.

Hospitalists are part of a new medical field that did not even exist 20 years ago. Prior to the rise of hospitalists, most internal medicine physicians, for example, would spent part of their day seeing patients in the office and part of the day “rounding” at the hospital to see their patients.

The specialization of hospitalists arose as many doctors wanted more time to increase their outpatient, office-based business. By training, most hospitalists complete an internal medicine or family medicine residency after completing medical school. Upon completing their training, they practice medicine only in a hospital setting, and do not have an office where they see patients.

General quality of care concerns

I have deposed a number of hospitalists in the course of medical malpractice and wrongful death lawsuits that I have filed for patients and their family members. From this experience, I have uncovered some common findings that merit mention.

First, hospitalists almost always have no past knowledge of or relationship with their patients. Thus, they do not know about their patients’ past medical history, medications, illnesses, or other conditions.

Second, many hospitalists are excessively rushed for time and see patients at multiple facilities. For example, I sued a Sugar Land, Texas hospitalist in two separate cases. In the second case—a wrongful death matter—the hospitalist produced his resume, which stated that he, “Treated more than 125,000 patients over the past 14 years in 10 nursing homes, 10 hospitals, and clinic.” I found that statement rather astounding and did the math. Presuming that he never took a day off in 14 years, this hospitalist saw over 24 patients a day, seven days a week, 365 days a year, for 14 years.

Third, hospitalists are often one of multiple cooks in the kitchen. One of the cases that I handled against the Sugar Land hospitalist involved care that he provided to a patient who had just gone through an orthopedic surgery. While the hospitalist was in charge of managing the patient’s medications, he claimed that the orthopedic surgeon was in charge of the pain medications. In that case, it seems that both doctors were in charge, but yet neither was in charge. As a result, the patient passed away from complications of a pain medication overdose.

Fourth, some hospitalists pop their head in the room to introduce themselves, without asking the patient any questions or obtaining any direct information about the reason the patient is hospitalized in the first place.

Inexperienced hospitalists

In December 2017, the Journal of the American Medical Association (JAMA) Internal Medicine published an article entitled “Association of Hospitalist Years of Experience with Mortality in the Hospitalized Medicare Population.”

The authors of the study notes that a substantial number of new doctors, fresh out of medical school and residency training, are choosing to become hospitalists. These new doctors are expected to manage the care of hospitalized patients with complex medical conditions and needs, even though the hospitalists have little to no experience in seeing patients without supervision from more senior physicians.

The authors considered the question of whether the amount of experience of hospitalists affected the death (mortality) rate of their patients. Their study looked at a 5% sample of Medicare data for the factors of hospitalist experience and patient death (mortality) rate.

Interestingly, the researchers found that a full 25% of hospitalists caring for the patients had one year of experience or less.  They concluded that there was a significant association between hospitalist experience and the death rate. In other words, patients cared for by hospitalists in their first year of practice had a higher death rate.

What you can do

If you or a loved one is hospitalized, it is a pretty sure bet that a hospitalist will be involved with the care. You can help increase your odds of a safe hospitalization with these two tips.

First, talk to your hospitalist. Start by asking them to come into your room. Then, have some questions ready. Ask them to explain their role in your care. Ask them about any lab or diagnostic imaging (for example, MRI or CT scan) results. Tell them about your medical condition, what brought you into the hospital, and any medications that you have been taking. Ask them to explain any orders that they are making for you.

Second, if the patient takes a turn for the worse, ask the nursing staff to get in touch with both the hospitalist and any other doctor, like a surgeon, who has primary responsibility for the hospitalization. This can help prevent things falling through the cracks, with the hospitalist thinking the surgeon is responsible for parts of the care, and vice versa.

We are here to help

If you or a loved one has been seriously injured as a result of hospitalist malpractice, call the experienced medical malpractice lawyers at Painter Law Firm, in Houston, Texas, at 281-580-8800, for a free consultation about your potential case.

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Robert Painter is an attorney at Painter Law Firm PLLC, in Houston, Texas. He files medical malpractice and wrongful death lawsuits on behalf of patients and family members, against hospitals, doctors, surgeons, anesthesiologists, pharmacies, and other healthcare providers. H Texas magazine named him one of Houston’s Top Lawyers in 2017.

Robert Painter

Robert Painter is a medical malpractice lawyer at Painter Law Firm PLLC.

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