BROOKINGS – Dr. Natalie Owens-Sloan is new to the Brookings Health System staff, having been on the job for about three weeks.
And the South Carolina native, whose southern accent gives her away as a non-Dakota native, is part of a program that’s new to the Brookings Health System: she’s a “hospitalist.”
“A hospitalist is a doctor who is trained in hospital medicine and specializes in caring for patients in a hospital setting,” the BHS website explains. “A hospitalist works closely with other members of the hospital care team to provide comprehensive care during your stay.”
Additional advantages of the program are that it provides “more physician time at the patient’s bedside and quicker physician response to patient emergencies.”
Sloan graduated from Clemson University (South Carolina), attended Ross University School of Medicine in the Caribbean and completed an internal medicine residency at the Medical College of Georgia.
“It is a relatively new area of medicine,” she said of her work at the Brookings hospital. “It’s been around about 20 years. Most of us are internal medicine; there are some family practice trained as well.” There is not per se a residency program to credential hospitalists.
“We had kind of three tracks: Outpatient, then we had the traditional model inpatient-outpatient, and then they did have a little track for hospitalists, where we got more inpatient work, more ICU (intensive care unit), more CCU (coronary care unit),” the doctor explained of her own internal medicine residency program.
Sloan shares hospitalist staffing and assignments with three additional physicians: Drs. Matthew Swartz, Catherine Leadabrand and Nazir Delawar. The four work on a rotating schedule, doing a week on duty at a time.
Sloan laughed a bit when asked to describe “a typical day” on the job, which is 8 a.m. to 8 p.m. through the week. This time around, she had come to work on a Tuesday and would be on duty until the next Monday.
“We have our local docs who take call for us at night. And we’ll do admissions and take cross-cover on the patients. And on the weekend, I’m on call until Monday; I’m in-house.”
While she’s new to Brookings, she’s not new to practicing medicine as a hospitalist. “It’s not as new as you would think,” Sloan explained. “I’ve been one for 10 years. And the practice I initially joined in South Carolina had been going about 10 years before that. We now have our own society: The Society of Hospital Medicine. They’re actually meeting this week in Las Vegas.”
Looking to the genesis of the specialty, the doctor explained, “I think a lot of it was primary care physicians being overwhelmed in the outpatient setting, more and more patients in the hospital, sicker patients.
“They have clinic from 8 (a.m.) to 5 (p.m.). There’s no time to see those patients. They could come earlier, but then if something happens, say at lunch, there’s no time to come back over. So this way there’s a doctor physically in the hospital that knows about the patient at all times.
“I think in terms of responding to things quicker, maybe getting things taken care of a little bit better, that’s kind of where we came in. And just being available for patients.”
As to getting the needed information on the patients being cared for, Sloan said, “We’re kind of detectives. I spend a lot of my time reading charts, getting information, talking with patients, with families, with their primary doctor if I can get a hold of them. You do a lot of patients.”
The average daily census for the Brookings hospital ranges from about 12 to 20 inpatients.
Karen Weber, medical, surgical and emergency room director, said the Brookings Health System started the Hospitalist Program on Feb. 13. She agreed with Sloan that “the physicians’ clinic practices are very busy,” adding that the program is also a good recruiting tool for bringing in new physicians.
“A lot of the bigger cities, they already have hospitalist programs and physicians are coming out of residency hospitalist-trained. So I think to recruit new office physicians, we went that route. It’s kind of a partnership,” Weber explained.
“We definitely still keep the primary physician very involved in the patient’s care. They do have a phone conversation with the hospitalist to gain acceptance if they have a patient in the clinic that they want to admit to the hospital.” Then when a patient is discharged, the primary care physician is notified.
“We arrange for the follow-up appointment and then provide all of those records to the clinic. So there’s great continuity of care. We pride ourselves on communication,” Weber added.
Julia Yoder, BHS marketing and public relations director, noted that there is a need for a positive “quality of life” impact on the recruitment of young physicians.
“For the primary care doctors, especially those coming out of college, they are expecting and wanting a quality of life. They want to have that work/life balance. So this program helps us to accommodate that,” Yoder said.
She noted that while hospitalists oversee the care of adult patients 15 years of age and older admitted to the Inpatient Care Unit, pediatric, obstetrics and surgical patients are still seen and cared for by their respective specialty physicians.
The program has been well received by hospital staff, patients and families.
“We were nervous initially going in, because people really like their primary care physicians. But the response has been overwhelmingly positive,” Yoder said.
Weber added, “We make sure the patient knows that their primary care physician knows about their hospital stay. And that’s reassuring to them, as long as they know that we’re in communication and when they go back to see their doctor in the clinic that he or she is going to have the information needed to safely continue on with their care.”
Contact John Kubal at [email protected]