Hospitals Are Employing
Many New "Ists"
Last week I received a mailing from a hospital where I learned about a new type of doctor I had never heard of before – a nocturnist.
Nocturnists are among a new breed of “ists” to appear in hospitals, most of whom patients know little about. Hospitalists, proceduralists, intensivists – more about what they do in a moment. First let’s look at why they exist.
Hospitalists came first. The term was coined in 1996 for doctors, nurse practitioners and physician assistants who focus their entire practice on hospitalized patients. As the numbers and types of specialists began to grow in the 1990s, care became more fragmented, and patients were not always receiving well-coordinated care. From conflicting orders for medical tests to problematic drug dispensing, patient safety was at risk. Further, primary care doctors could not keep up with a large number of hospitalized patients plus increasing patient loads in their offices. So hospitals began to employ hospitalists to help improve patient care and safety.
It didn’t take long for hospitals to discover that the use of hospitalists was a more efficient and profitable way to run their businesses, too. Since the hospitalist was reimbursed for the patient’s stay in place of the patient’s regular doctor, hospitals could make more money from that patient’s stay. Employing hospitalists turned out to be win-win for hospitals and patients.
So smart hospital business people began to think of ways to implement more systems of “ists,” capitalizing on what they had learned about improved patient safety, coordinated care, and increased income brought about by hospitalists.
Voila! Plenty of new “ists” found in hospitals today.
Among them are:
Proceduralists: doctors and surgeons who perform one or two procedures like lumbar punctures or PICC line insertions over and over again, all day, every day.
Interventionalists: proceduralists who mostly perform heart-related interventions like angioplasties or stent insertions.
Intensivists understand all that high-end technology that keeps intensive care patients alive.
Radiologists read CT scans or MRIs but rarely treat patients at all.
Nocturnists are surgeons and other specialists who work overnight because they are needed for emergencies at odd hours. More “ists” are being developed every day.
If you are hospitalized and a doctor you don’t recognize begins to treat you, be sure to ask who he or she is and what role they play in your care. You may just find your new provider is an “ist.”
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Trisha Torrey
is the author of
You Bet Your Life!
The 10 Mistakes
Every Patient Makes
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Health Care You Deserve)
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