Mid-Columbia Medical Center: Hospitalist transition


A key weapon in Mid-Columbia Medical Center’s response to a national shortage of internal medicine doctors is its plan to expand and make permanent its use of hospitalists to provide around-the-clock care to hospital patients after Sept. 1.

Hospitalists? Simply put, hospitalists are internal medicine physicians who work exclusively with patients who have been admitted to the hospital. At the outset, the hospitalists will handle care of patients admitted by internal medicine doctors, and also may partner in care of other patients if their physician request.

“It’s a bold move for a 49-bed community hospital to staff with physicians 24 hours a day, seven days a week,” says Dr. Tom Hodge, medical director for the Mid-Columbia Medical Center.

Here’s how it works. Six hospitalists will work in two teams of three each. Each team will work for seven days, then take seven days off. A new team will take over at 7 a.m. each Friday. Two members of each team will work during the day. The third hospitalist on that team will work the night shift.

Two longtime local internal medicine doctors are transitioning from their private practices to take lead roles with the hospitalist group. Dr. Thom Nichol will lead the effort, and head one of the teams. Dr. Gretchen Blair will head the other team.

To fill out the teams, the hospital has hired Dr. Samir Faris, Dr. Mohamed Ahmed, and Dr. Jayaprakash Reddy (see sidebar). Two other physicians have shown serious interest in the last position, and one will be on board by Sept. 1 when the teams begin work.

Hodge says the major benefit of hiring and employing hospitalists is that it will reduce growing pressure on the community’s internal medicine doctors. Several have left the community in the last year, increasing the workload on those who remain.

“A huge part of the problem is that doctors burn out before we can get them help,” Hodge says.

Hospitalists will lift the burden from internal medicine doctors of working “on-call”. By not having to rush to the hospital whenever a patient’s condition requires urgent attention, doctors can focus on patients in their offices. Patients will know that their doctor won’t be called away, canceling appointments often anticipated for weeks in advance.

And because doctors will regain office hours previously lost to hospital visits, they can provide more care, and for more patients.

“Patients will have better access to their doctor, because the doctors aren’t working in a ‘call’ rotation,” says Mark Ackley, director of the Mid-Columbia Medical Group, which provides business services to most of the community’s internal medicine and family practice doctors.

And because doctors can anticipate greater stability in their private practices, Dr. Hodge and others think MCMC will gain another hole card in its efforts to recruit permanent replacements for some of the physicians who have left.

Hospital patients also can expect to see benefits.

“They can expect more immediate feedback from the hospitalist, to themselves and their families,” Hodge says.

Having hospitalists in the hospital, in fact, is expected to increase and speed communications for everyone involved in patient care – from admissions, through the emergency room, to orders that require lab work or diagnostic imaging, to changes in medication or other direct patient care provided by nurses.

“I believe hospital care is becoming a more specialized field of practice, and it makes a lot of sense to do that in The Dalles,” says Dr. Nichol.

Ditto that, says Dr. Blair.

“In the hospital, you’re dealing with heart attacks, strokes, different levels of acuity than in the office,” she says. “There are different drugs in both settings, and the technologies and testing used in each are different.”

Caring for patients in the hospital is more demanding, Blair says.

“This is a better fit for me at this time of life,” Blair says. “I can do a better job if I choose one area to focus on.”