Dr. Bray Links

Monday, January 8, 2018

Hospital Medicine: Better, or Less Personal, Care?

"As the number of physicians caring for a patient increases, the depth of the relationship between patient and physician tends to diminish — a phenomenon of particular concern to those who regard the patient–physician relationship as the core of good medical care."

More physicians involved in a patient's care may result in miscommunication and discoordination of care, especially at admission and discharge.

"From the patient's point of view, it can be highly disconcerting to discover that the physician who knows you best will not even see you at your moment of greatest need — when you are in the hospital, facing serious illness or injury," Dr Gunderman explains. "The patient–physician relationship is built largely on trust, and levels of trust are usually lower among strangers."

Community physicians are also at risk for less professional and personal fulfilment when they do not oversee their patients' hospitalizations. Potential disadvantages for the medical profession include increased fragmentation of patient care, faster burnout, and less knowledge sharing and camaraderie.

Hospitalists may suffer from lack of outpatient experience, becoming less accountable to nonhospitalized patients and their communities, and therefore less effective advocates for comprehensive medical care. Their employment by hospitals may shift their loyalty away from patients and their profession.


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