Hospitalists: New Medical Specialty With Patients’ Overall Condition In Mind

Wednesday, March 31st, 2010 @ 5:53 pm | We Think

Dr. Edmondo Robinson is medical doctor with an MBA from the Wharton School at the University of Pennsylvania. He is an internist who completed residency at the Harbor-UCLA Medical Center. A 2003 graduate and Dean’s Merit Scholarship recipient of the University of California, Los Angeles, School of Medicine, Dr. Robinson participated in an AIDS Care Fellowship at the University of California-San Francisco AIDS Institute while attending UCLA. He also served as National Vice President for the Student National Medical Association and was an appointee to the National Board of Medical Examiners.

Dr. Robinson earned a master’s degree in business administration, with an emphasis in healthcare management, from the Wharton School at the University of Pennsylvania, during a two-year leave of absence from medical school. During his studies at Wharton, Dr. Robinson traveled as a member of a team of students and alumni to South Africa to make an assessment of state-sponsored, community clinic operations for the Director of Health Services for the Cape Town Metropolitan Region.

Dr. Robinson graduated from Wharton with honors in 2002. He completed his undergraduate degree in Neuroscience at the University of California, San Diego, in 1997. His research interest involves the development of indicators to measure the value and quality of health care delivery to special populations. One can readily see Dr. Robinson’s credentials make him eminently qualified to be a member of the medical profession’s newest specialty. Dr. Robinson is a hospitalist. His practice is near Delaware’s Christiana Care Health System.

One of Robinson’s responsibilities is to ensure patients are not unnecessarily readmitted because of gaps in care between release from the hospital and care from the patient’s primary physician.

“I get a sense that the patients are relieved because somebody is actively following them.”~ Dr. Edmondo Robinson, Hospitalist

The new federal health care reform legislation contains a provision to withhold funding for readmissions believed to be avoidable. Hospitals, health care systems, are realizing the rates of readmission must be improved. Federal statistics show one in five Medicare patients repeatedly end up in the hospital requiring care for major health issues.

That is why hospitals, such as the Christiana Care Health System in Delaware, like many other institutions, are making use of the expertise of medical specialist practitioners known as hospitalists.

The term “hospitalist”describes a new specialty. The term was first coined by Drs. Robert Wachter and Lee Goldman in an article, The Emerging Role of “Hospitalists” in the American Health Care System, appearing in 1996 in the New England Journal of Medicine.

Often, according to Wikipedia, the Hospitalist duties may include patient care, teaching, research, and leadership related to hospital care.

Last year in 2009 the Society of Hospital Medicine updated the definition of this new area of specialized medicine to state Hospital medicine, like emergency medicine, is a specialty organized around a site of care, the hospital; unlike a specialty such as cardiology, it is not organized around an organ, nor a disease like oncology, nor a patient’s age like gerontology.

Reports from the Society of Hospital Medicine, a national membership organization for hospitalists indicates the ranks of this specialty is increasing at a rate higher than any other medical specialty. The federal government’s expressed intention to reduce payments of Medicare is the reason hospitals are expanding hospitalist staff numbers.

In a recent interview with Delaware Online, Dr. Robinson said patients are more sick when they enter the hospital, and they are still often sick when they leave the hospital. That is why

“…it’s very important to continue the treatment as an outpatient. You have to plan around that and not just rely on their first follow-up with their own doctor in two or three weeks.”~Dr. Edmondo Robinson, M.D., MBA, Hospitalist

Robinson started the discharge clinic near Christiana Hospital in order to address the issue.

Patients with serious illnesses, who are recently released from the hospital, sometimes are unable to be seen by their primary care doctor in a well timed way. In those instances they receive an appointment scheduled at the clinic within a week.

Patients who receive the interim care report they are satisfied with the time saved from return trips to the emergency room. They additionally report the care they receive from a hospitalist provides confidence the risk of having to return to be admitted to the hospital is smaller as well.

That is why Dr. Edmondo Robinson has the expectation the readmission rates will decline at the Delaware hospital. He is among one of approximately 50 hospital medicine specialists with privileges at or employed by Christiana Care.

With the use of electronic medical records hospitalists say the rate of readmission will be reduced. Primary care physicians will received up-to-date case information on their patients when they leave the hospital.

Hospital medicine practitioners agree, with the government’s emphasis on readmission rates the place to save money is by making the discharge process efficient and beneficial to the patient’s care.