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Dr. Jennifer Bennett is the new hospitalist at Wythe County Community Hospital. Bennett’s job is dedicated to providing care for hospitalized patients. Photo by Jean Farley

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‘Hospitalist’ health care

By NATE HUBBARD/Staff

Your loved one is in the hospital. You’re worried and have question after question running through your head. You need answers fast.
No worries, Dr. Jennifer Bennett is there.
Bennett is Wythe County Community Hospital’s hospitalist, a new position at the hospital committed solely to the treatment of hospitalized patients.
The hospitalist movement has become a nationwide trend as more and more primary care physicians no longer practice hospital medicine.
“You have a dedicated physician here the majority of the time to handle any kind of problems or answer any questions, things like that,” Bennett said about the benefits to WCCH’s new program.
The hospital made the transition to the hospitalist program on Jan. 1. Bennett is leading the program and for now is the only doctor offering care. Bennett said hospital staff has been conducting interviews to hire a second hospitalist and that she even hopes eventually to add a third doctor to the staff.
In the interim period, Bennett said she has been relying on locum tenens (temporary physicians) to help her provide care. She also is assisted by Kelly Hale, hospitalist administration coordinator, who Bennett said she relies on for obtaining patient records and other information from patients’ primary care physicians.
According to the Web site of the Society of Hospital Medicine, which was formed in 1997, there are approximately 20,000 practicing hospitalists nationwide. The society calls hospital medicine “the fastest-growing medical specialty in the U.S.” and estimates that there will be 30,000 hospitalists in the country by 2010.
Citing a 2006 study, the Web site also said that 40 percent of U.S. hospitals have a hospitalist program.
Prior to the Jan. 1 change, primary care physicians affiliated with WCCH cared for patients both in their offices and at the hospital. Now when most patients are admitted to the hospital either by referral from their family doctor or through the emergency room, Bennett takes over their care during their hospital stay.
Any follow-up care is then transferred back to the primary care physician after the patient is released from the hospital.
“I’m not doing anything different than I’ve done before,” said Bennett, who worked as a family doctor at Rural Retreat Family Practice prior to accepting her new job. “I’m just doing a lot more of that one part of the hospital physician. I’m here full time now so I don’t have to run back and forth to my office.”
Doctors affiliated with Fort Chiswell Family Practice and Rural Retreat Family Practice now turn their patients’ hospital care over to Bennett.
All doctors at Carilion Family Medicine in Wytheville besides Dr. James Stone III also are participating in the new program.
In a phone interview Thursday afternoon, Stone emphasized that he believes that hospitalists provide quality care.
But Stone added that his personal viewpoint deviates from the new trend.
“I’m doing this against the flow,” he said about his decision to maintain both inpatient and outpatient care. “It’s just a different philosophy.”
Stone said he simply sees it as part of his job description to offer care in both venues. He did acknowledge, though, that it can be difficult for doctors to keep regular office appointments when they have a particularly ill, hospitalized patient.
Dr. James McConnell and the family physicians at Wythe Medical Associates also are continuing to practice medicine both in their offices and at the hospital.
Stone, who has been a doctor in Wytheville for 35 years, also said that it can be difficult for a primary care physician the next day if he has to make a late-night emergency hospital visit. However, he said that on-call duty is manageable as doctors within a practice rotate those responsibilities.
When he began practicing medicine in Wytheville, Stone said he had to be on-call every third night and every third weekend. He now said his rotation requires on-call duty only every seventh night and every seventh weekend.
With the rest of the Carilion physicians now turning over their hospital care to Bennett, Stone said he’s working within the on-call schedule of the doctors at Wythe Medical Associates.
“I don’t see it being that bad,” he said. “This is what I was trained to do.”
Although he again stressed that he has confidence in the abilities of hospitalists, Stone also said that nobody knows a patient better than their primary care physician.
Bennett didn’t dispute Stone’s viewpoint, but said that the advantages of having a doctor dedicated to hospital care outweigh the concerns associated with a hospitalist’s lack of prior relationship with a patient.
“In some ways the continuity that some people want is gone, but there are so many other benefits because I’m there for the families and I’m there if there is problem,” she said.
She added that her communication with primary care physicians is essential to the job.
“The whole key to offsetting the lack of continuity is that I have to be in contact with the primary care,” she said. “You can’t do without it. Because who knows that patient best? The primary care doctor.”
Bennett also said that nothing in the new program prevents family doctors from making an appearance at the hospital to say hello to their patients.
“We actually still have some that don’t come and admit, but they’ll just come and do a courtesy visit just to let the family know ‘hey I know what’s going on and Dr. Bennett’s taking good care of you and I’ll see you when you’re around,’” she said about the primary care physicians that no longer practice hospital medicine.
Patients, though, don’t have the option in the new program of having their family doctor administer hospital care instead of Bennett – short of changing doctors beforehand to one of the physicians in the area who continues to work both in their office and at the hospital.
So far, Bennett said the hospitalist program seems to be running smoothly, although she still is trying to get administrative tasks organized.
“The patient care didn’t miss a beat,” she said. “It’s the business side, you know getting your office set up and getting all the paperwork and the stationary and all that other stuff and that’s typical of a new business.”
On a typical day, Bennett said she sees about 12 patients. After doing rounds throughout the day and checking on new patients, Bennett said she normally returns home before briefly returning to the hospital for final check-ups in the early evening.
Bennett also is on-call 24 hours a day for week-long shifts, although she said that her on-call schedule has been extended a few days longer when locum tenens were not available to fill in. Once a second hospitalist is hired, however, the pair will rotate on-call shifts.
“I’ve had great interactions with patients,” Bennett said. “I guess most of them really appreciate that I’m here.”
Nate Hubbard can be reached at 228-6611 or .