Patient in a hospital bed waiting for her doctor. She’ll have a long wait.
Something happened recently that made me want to scream, “I Want My Doctor!” Today I had an appointment with my Veteran’s Administration doctor. He’s a fine doctor, very thorough with his examinations and easy going and friendly with patients. Even the nurses he works with and the young doctors he trains at the VA all have good things to say about him. I trust him, he’s always told me the straight scoop about my ailments, doesn’t whitewash anything. I like that he speaks to me as an intelligent being, instead of talking “down” to me. So we have a great relationship, both of us working for my health.
Many of us enter hospital through the Emergency Room
Modern Medicine Changed
Before I began going to the VA I was hospitalized a few years back in a civilian hospital. I didn’t know it but I was to experience something totally different from previous times, since it was my first hospitalization in years. I realized from that hospitalization that modern day medicine is greatly changed. The day I went to my doctor because of experiencing breathing distress, my doctor took one look at me and knew what to do, he sent me to the hospital emergency room. Of course, he had all my records, was responsible for my care and knew all about me, so you would think he would have been my doctor at the hospital. I didn’t see him once during my time there and it wasn’t because he was neglectful. There’s a new way medicine is performed these days. The current procedure prevents my doctor from being the attending physician. Instead, a “Hospitalist” visited me. If I’m lucky, I might see the same one twice or three times, but it could just as well be a different person each day. And even though each of them had access to my records, it was obvious that they never bothered to read them. I’m sure with so many patients to see each day, they couldn’t possibly devote that much time to reading records.
Principles and Practice of Hospital Medicine
Waking To A Strange Person
I was almost unconscious the day I was taken into the hospital by ambulance. When I managed to awaken for a moment, there was a strange person looming over me telling me he was my “Hospitalist.” I had no idea what that meant, and I was so sick I didn’t care. So many people came in and out with various titles, I couldn’t worry about it, I just wanted my doctor and to be left alone until then. Since then I’ve discovered most of these “Hospitalists” may be in various stages of training to be a doctor or have recently received their diploma. Many have no bedside manner and are in a hurry because they have so many patients to see before their day ends. They come in, give a short, quickly-gone smile on arriving and say “Ms. What’syourface, I’m Doctor Whoknowswho. Tell me why you’re here.” When you’re really sick, as I was, having trouble breathing, unable to sit up, going through the same list of symptoms every day is sheer agony. The meeting lasts only a few minutes, with the “Hospitalist” reassuring you that everything will be done to take care of you, but still, the next day, someone else may appear, and it begins all over again.
Why doesn’t the Hospitalist
read your records?
My Family Was Told I Am Dying
I came close to dying, being admitted three different times to the hospital in a single month. Even with all the tests, it took a while for them to discover that I had bacterial pneumonia in both lungs. With my emphysema/COPD complicating matters, I came very close to experiencing my last day on earth. My family were called into the hall and told to be ready for my demise. But did I have the doctor I had gone to for years to see me through this cruel siege? I most certainly did not. I only had a robotic-like “Hospitalist,” who knew nothing about me.
“When Do I See MY Doctor?”
As soon as I was able, I asked when I would see the doctor, and mentioned that I hadn’t seen him yet. They told me you’ll see him today, you’ve seen a doctor every day you’ve been here. Of course they smiled pityingly at me as they said this because they thought I was a bit goofy, since I’m old and sick. Gathering my strength I asked, “Yes, but when do I see MY doctor,” and they patiently explained to me that a “Hospitalist” makes the rounds, not my doctor. I managed one word “Why?” Their answer was “Your physician will not come to see you, it’s different now. This system is more efficient.” When I asked “More efficient for whom?” they simply smiled and told me not to worry. After all, I was an old lady, probably on her death bed, so soothing me was more important than answering my question.
Hospitalists’ Guide to the Care of Older Patients
Maybe The Veteran’s Administration Is Different?
I survived those three hospitalizations, and it took about six months for me to get on my feet again. At the present time, I no longer see civilian doctors, but since I am a veteran, I now see those at the Veteran’s Administration, so I thought perhaps it would be different. But my doctor, with whom I have developed a bond and trust, sent me to the VA Hospital emergency room a few weeks back, and guess what? He can’t come there to treat me, he has to use a “Hospitalist,” too.
How Did This Happen?
How did this happen that we no longer have access to our own doctor when we are hospitalized? More to the point, WHY did it happen? Actually it comes back to us and our world. Not only is it considered more efficient for the caregivers and more cost-effective, but most doctors like it too. In our lawsuit happy world, they don’t have to carry such huge insurance policies covering them for malpractice. The hospital itself provides for that possibility and keeps a phalanx of lawyers retained for the purpose of fighting any suit brought against them. I feel it’s a sad commentary on our times, when the doctor who has helped us through so many ailments, is not allowed to attend us when we are sick enough to be hospitalized. And that strangers we do not know, may be the last people to attend us as we die.
Please tell me in a comment which of the following best suits you and why it does.
- Hospitalists are fine for treating me when I’m in hospital.
- Hospitalists should not be treating me when I’m in hospital.
- I want my doctor!
- I don’t care either way.
I want my doctor!!
Through out my pregnancy i haf the same amazing doctor, i being a first time mom who watches to many movies assumed i would have my doctor deliver. To my surprise i did not have my doctor, and the nurse and doctor taking care of me in the beging left. So by the time i was ready to deliver i had a stranger i met 3min before being told to push. It was very uncomfortable, and impersonal. I was a number in some room, not a person scared and in pain. I love you nancy, you are so wise.
Alexa, unfortunately, it’s the face of modern medicine. I detest it, it’s too impersonal and it was foisted upon us, the unsuspecting public, without our consent. When I’m sick I want the reassurance of my doctor, not someone I met 3 minutes ago. Thanks for the visit and the comment! 🙂 <3
I know what you mean, and I want my doctor too! A few years ago I was admitted to the hospital. Over the next hours and days, many doctors came through my room. Each time, I had to answer the same questions over and over again. One after another, the doctors prescribed this medication or that test, and each time I had to tell my story again.
Not only that, but they ended up doing a surgical procedure and, because the hospital was undergoing renovations, my surgery took place in the ambulance garage! They had put up a sheer plastic wall between us and the vehicles. My operating table was shoved up against a huge wall of boxes covered with black plastic. I couldn’t help wondering how sanitary that place could be.
Not once in those three days did my physician visit. I kept thinking she would come and explain what was going on and why I was seeing so many different people, but she never did. I hope I’m never so sick or scared that I have to go to a hospital again. For you, I pray for ease, because I have witnessed how painful emphysema can be. May you be blessed every minute of every day, as you bless so many of us.
Kathryn, what a terrible experience you had. I hope and pray that you never have it again. Modern medicine has certainly “taken a turn for the worse,” as more and more people have stories like yours and mine. The patient is no longer the priority; the money that can be made is what matters. Dear friend, thank you so much for your visit and your comment. 🙂 <3
Nancy, thank you for sharing your experience. Just when you want to see that familiar face the most, it’s when you don’t get them. A personal relationship with your doctor is so important, and it would save so much strain in situations of greater illness. I would want my doctor as well. Unfortunately, it doesn’t seem like our systems will bring that kind of treatment back, so hopefully they can do something to ease the strain on the patient in the future.
Monica, yes that doctor-patient relationship has traditionally been one of bonding with someone whose judgment you trust. Now, the moment you enter the door of a hospital, your health care is in the hands of someone completely unknown to you. There’s only one reason why this is done; money. It’s sad that it has come to that, but there it is. Thanks for your visit and comment. 🙂 <3
I can really relate. When I was in the ICU this week, I kept wondering when I would see my doctor. I didn’t know about hospitalists. Nobody had time to explain the results of the many tests that were run. It was a very different world from previous hospitalizations. Even at my doctor’s office I never actually see my doctor. I guess it is now a system of doctorofficeists. And I’m not even on an HMO plan.
Diana, that’s really terrible that you couldn’t see your doctor even at his office. I understand that doctors are busy people, but I feel they’ve lost sight of what’s important; the patient. It doesn’t even matter what insurance you have, or in my case now, the Veteran’s Administration. Someone, somewhere decreed that this is the way all hospitalizations should be handled, and so it is. When my son was shot on the 14th of November during a robbery of our car, he was sent to the hospital for exploratory surgery to see if his intestines had been punctured. (Thankfully, they weren’t.) He actually got to see his surgeon, and visit him later at his office to have the stitches removed. I was very grateful for that, but unless you get shot, you won’t have that sort of treatment it seems. Thanks for the visit and the comment. 🙂 <3
I first met a hospitalist when my mom was waiting for her first appointment with whom she hoped would be her new primary physician. our mutual doctor had just retired and we were scrambling to find a new one. Although most doctors were still visiting their hospitalized patients, Mom didn’t have a doctor yet. The doctor she was hoping for came anyway, before they had a first appointment. I really liked her and I was also on her waiting list for a first appointment. As it turns out, she was the one who discovered my mom’s advanced cancer. She was very good about the way she explained the options and we decided on Hospice in home care. I never got my first appointment with the doctor though. She left private practice to become a hospitalist.
When I finally got a new doctor, she told me she visits her own patients. I can’t honestly remember if my neck surgeon visited the hospital to release me, since I was only there overnight.
Unfortunately Barbara, if you’re ever hospitalized again, expect the treatment described in this article, because it’s the way modern medicine is done these days. My complaint is that the patient is not the primary focus now; money is. A hospitalist makes a lot of money for sticking their head into a patient’s room and asking a couple of questions. Your doctor isn’t allowed to visit you in hospital, much less actually prescribe your medical treatment. Thanks for the visit and the comment, my friend. 🙂 <3
I remember when my husband made hospital rounds early in the morning before going to the office. The hospital is about 25 miles away. He would often return to the hospital during lunch and again after seeing 60 to 70 patients in his office. He would then be on call for emergencies and often would return to the office, hospital, or make a house call during the night. The doctors now would never do this. Most of the offices are now owned by the hospital and the doctor has a quota to meet and then is through for the day. They can refuse to see someone in the office if it doesn’t fit into their schedule. My husband never refused to see one of his patients even if it meant keeping the office open for another hour. Yes, times have changed and the care we had grown accustomed to has certainly changed.
Nancy, of all people, I know you know what the difference is between the care we received from a practice like your husband’s and what we receive now. The people who “treat” us at present, know nothing about us. It’s very impersonal, when back in the day our doctor knew us and we kept the same doctor throughout our medical needs, unless he or she retired. Today in hospital, you never know who you’re going to see from one day to the next. There’s no continuity of care, and there’s little concern for the individual. A patient is just another number to be checked off the list of that day’s Hospitalist. What a shame that it has come to this. Thanks for your visit and comment. Hello to Doc and Bruno! 🙂 <3
Nancy, thank you for sharing your experience. I certainly learned something new. I should have known since both of my parents were hospitalized numerous times in the past decade before they passed away. At the time, since their condition was serious, I just assumed they required a specialist so that was why someone else was their attending physician at the hospital instead of their regular doctor. Silly me!
Vicki, this entire change was brought about so gradually that most of us didn’t realize it was happening. I had no idea why so many people came in and told me they were “Dr. Whatshisface,” and then I’d never see them again. I didn’t realize it was a whole new system of medicine being brought about in our society, until finally over the past few years, I began to realize I would never get to see MY doctor when in hospital. It’s wrong, the patient should be the focus, not the bottom line of money. Thanks for the visit and your comment my friend. 🙂 <3
Seriously. First, sorry you were so sick, and glad you recovered. I hate to say this, but I am glad to live in a country where MY doctor will still do house calls if needed, but nearly always rings us for a follow up if someone in the family is sick.
Rhonda, the lesson to be learned here is, be happy with what you have and if it’s not broke, don’t fix it. I liked the days when my doctor came to the hospital and made rounds. He’d stop in, examine me, ask me how I’m feeling and if needed, prescribe something for me. Sometimes, it was a short visit, if I’m on the mend and seem to be just about ready to leave the hospital. The point is, I was a PERSON, not another on a long list of room numbers to be checked off on the hospitalist’s list. We were visited with this change in our medical system with such subtlety that we didn’t even realize it was happening, until it was an accomplished fact. Now we’re stuck with it, and it’s not a good thing for anyone except the hospitalists who are making money. Thanks my friend, for the visit and the comment. 🙂 <3
“Efficient” only means it saves them money. It does NOT mean that people get better care.
Jonathan, exactly right! The patient is no longer the focus of health care, money is the focus. Thanks for the visit and the comment, my friend. 🙂 <3
Scary isn’t it? Efficiency over everything leaves you prone to a lot of angst. I would be screaming where’s my doctor too!
Olivia, what it really comes down to is money. A hospitalist doesn’t have to care about you as a PERSON, you’re just another check mark on his daily list. Our medical system really is broken and badly needs to be fixed. The patient should be the focus, not how much money or how quickly x-number of patients can be seen. Thanks for the visit and the comment, my friend. 🙂 <3