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Hospitalist Program—

Fully Focused on Inpatient Care

Patients admitted into Milford Regional Medical Center (MRMC) have met a new type of doctor they may be unfamiliar with; physicians whose sole responsibility is overseeing the care of inpatients and making their experience as comfortable and stress-free as possible. These physicians are referred to as hospitalists.  They work only in the hospital, where they treat patients from admission to discharge.

Tri-County Medical Associates, Inc. (TCMA), a multi-specialty physician group practice affiliated with MRMC that emphasizes primary care in 20 office locations within Milford Regional’s service area, operates the TCMA hospitalist program based at the Medical Center. With 20 hospitalist physicians and 2 hospitalist physician assistants on staff, the Medical Center is covered 24 hours a day/ seven days a week.

“Our goal is to get the patient through the system as quickly and efficiently as possible,” said Tina M. Robakiewicz, MD, Medical Director for the TCMA hospitalist program. “We’re accessible to answer questions from the nursing staff; we’re available to quickly reassess if there’s a sudden change in a patient’s status; and we’re here for the patients and their families at a time when they’re feeling vulnerable and stressed, providing medical expertise, reviewing test results, answering questions and providing emotional support.”

According to the Society of Hospital Medicine, when the specialty was initially established, there were approximately 500 hospitalists. Over the past decade hospitalists have grown to over 30,000 doctors now practicing and the association anticipates there will be more than 40,000 hospitalists in the next few years. Dr. Robakiewicz said ongoing changes in the medical field have led to most hospitals having these specialists on staff, one of the chief reasons being increasing pressure on primary care physicians. “They need to devote their time and energy at the office, at the same time that patients in the hospital are sicker and need a lot of direct care,” said Dr. Robakiewicz. “Clearly, the primary care physician can’t be in two places at once, so the hospitalist can be their eyes and ears.”

As a result, she said patients and families receive medical tests and responses to their questions much quicker, and incoming patients from the emergency room have shorter wait times for evaluation by the admitting physician. In the meantime, the patient’s primary care physician is kept fully informed, said Dr. Robakiewicz.

A patient’s primary care physician is typically notified upon admission, discharge, and if there are significant changes, she said. If a patient requires a specialist, or has a specialist for a particular problem, hospitalists will often involve those physicians in the treatment plan.

According to Dr. Robakiewicz, patients are sometimes surprised to learn they won’t see their primary care physician. To help with the transition, she said hospitalists strive to ensure that whichever doctor handles the initial assessment is the same familiar face following the patient throughout their inpatient experience. “We’ve gotten such positive feedback from patients and families who are so thankful that we’ve been accessible to meet with them and address their concerns. Their apprehensions quickly disappear,” she said.

Patrick R. McSweeney, MD, a primary care physician with Family Medicine Associates in Medway, said that he has been able to expand his office hours beyond the standard 9 a.m. – 5 p.m. because hospitalists are caring for his patients admitted at Milford Regional. Now, he starts an hour and a half earlier each day and is accessible one evening per week.

“It’s much more effective to have the hospitalists right there seeing patients in a shorter time-frame, rather than having primary care physicians leave the office at lunch and be back late for office patients, or having to go to the hospital late in the day,” said Dr. McSweeney. “As long as patients know the hospitalists are communicating with us, they are usually at ease. Patients typically come in for follow-up at my office within two weeks of discharge. These same patients appreciate the extended hours I now have in the office.”

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