Understanding a hospitalist's role

The doctor that visits a patient while they're hospitalized will most likely not be their primary care practitioner. Doctors that take care of hospitalized patients are called hospitalists. A hospitalist's primary focus is the general care of hospitalized patients. Most hospital systems use hospitalists in some capacity. Blanchard Valley Hospital System uses hospitalists for adult, pediatric and emergency medicine care. ProMedica, Mercy Health, The Cleveland Clinic and The Ohio State University Hospital System all use hospitalists in some capacity as well. "Starting out when a patient gets admitted, (hospitalists) will take care of them until they're released," said Dr. Bill Kose, vice president of special projects at BVHS. Hospitalists go through the same schooling as other doctors. As students, they attend four years of undergraduate school, four years of medical school, and then finish with a residency program for three years. Most will attend a general internal medicine residency, Kose said. Dr. Jigna Janani is a hospitalist and director of adult hospitalist medicine at BVHS. She joined BVHS a little over three years ago, right around the beginning of the COVID-19 pandemic. Janani said she often gets questions from patients confused about her role in the hospital. "When I try to explain to the patients, I usually tell them I'm more like your family doctor, just in the hospital," she said. "My favorite metaphor I use is, I'm captain of the ship, I'm going to lead the whole care or run the orchestra — I'm just your conductor and I'm going to make sure everything plays out well and your stay is really smooth and good." BVHS has about 17 hospitalists out of the 100 doctors employed at the hospital. Most hospitalists work seven-day, 12 hour shifts, followed by a week off. "They start their day at seven in the morning. They have usually around 14 to 16 patients to see. Some could be in the ICU, so they're all around in the hospital," Janani said. Hospitalists at BVHS work in tandem with the other areas of the hospital. "(Hospitalists) can go to the emergency room and admit people. They help out the emergency room," Kose said. "They follow (patients) during the hospitalization and then they come up with a plan of release. They work with social workers, they work with our pharmacy department." Janani said she and her team assess patients' medical history, their needs or if they need a specialist, and notify the family doctor when a patient is discharged from the hospital. "We have certain patients who absolutely want to see their primary care only. So you really have to warm them up that I am like your family doctor. And I've been in situations where they feel uncomfortable. You can sense it, you can read it," she said. When that happens, Janani said she puts the patient at ease by calling their family doctor to reassure them of the care they'll receive in the hospital. "It's really a team that makes the hospitalist program go," Kose said. Janani empathizes with patients' concerns of a hospitalist's role. She said she "doesn't blame them" for only wanting to see their primary or family doctor. "I would feel the same if it's my mom who's going and I don't see the family doctor," she said. "But then the more they know, I think the more awareness we can create in our community, that this is the national standard, the better — having family doctors in the hospital called hospitalists."