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Primary care providers and hospitalists: Stronger together

Arnold DoRosario, MD, has been a primary care provider (PCP) in Trumbull, CT, for 35 years. He and his patients know each other well. “They not only have a physician,” he says, “but a friend, an advocate, a counselor – someone who is always acting on their behalf.”

Twenty years ago, Dr. DoRosario would visit his patients daily during his rounds and oversee their care if any one of them was admitted into the hospital. Today, however, his inpatients, as well as those of his colleagues, are cared for by a hospitalist-- a physician who is trained to work exclusively in a hospital and is directly referred by a patient’s primary care provider. “Ultimately, patients get much better and more timely care from hospitalists, who specialize 24/7 in hospital medicine,” said Dr. DoRosario.

Dr. DoRosario, who is also the chief population health officer for Northeast Medical Group (NEMG), which includes 260 PCPs and 340 hospitalists affiliated with Yale New Haven Health System’s network of hospitals and outpatient facilities in Connecticut, Rhode Island and New York, is an enthusiastic proponent of  the coordinated interaction among PCPs and hospitalists. “The hospitalists are an extension of me. They are trusted partners who will provide a seamless continuum of care for my patients,” he said. 

The hospitalist system has evolved in the U.S. since 1996, and today there are nearly 60,000 practicing in most every hospital in the nation. “As soon as a patient is admitted, we are in direct communication with his or her PCP,” says Sheikh Mahfuz Hoq, MD, hospitalist director at Yale New Haven Health’s Bridgeport Hospital. They simultaneously access the patient’s electronic medical record (EMR) for details of his complete medical history.

“Hospitalists continuously update patient records, so primary care physicians  can track their patients’ care in real time, anytime,” Dr. Hoq says. “If there are major changes, or if a specialist is required, we communicate immediately.” They are again in touch when the patient is discharged, to summarize his condition, as well as to coordinate medications, any necessary outpatient care, and schedule a follow-up visit to the primary care provider.

NEMG fosters the vital relationship between PCPs and hospitalists through weekly leadership meetings and regular open forums. “This important focus on the continuity of care has reduced the rate of patient readmissions to the hospital and improved patient satisfaction and safety,” Dr. Hoq said.