Cheryl A. Geoffrion, M.D., another MIMS physician, said stays are reduced not only because fewer tests are ordered, but because when they are ordered, they can be administered more quickly. I'll order a CAT scan at 3 o'clock in the morning if something's going on with a patient, whereas if their primary care physician was taking care of them, he or she would wait until their morning rounds, and then put in an order for the test. If something is going on with the patient, I won't hesitate to order tests in the middle of the night. The primary care physician can't do that. All this communication is critical to the process of establishing trust, said Whitcomb, which remains an issue in overall acceptance of the hospitalist concept.
Some physicians remain uncomfortable with turning their patients over to an inpatient doctor.
Carrington said those fears are usually erased when the primary care physicians work with the hospitalists over time and become familiar with their working style. If the flow of communication is constant and efficient, he said, the primary care physician often doesn't have to visit a patient at the hospital at all. As for the patients and their families, many are not aware of the program when they are first admitted, said Oppenheimer, and are somewhat surprised that they will be cared for by someone other than their regular physician. However, most become comfortable with the concept quickly. To establish trust with your patients you start by telling them that you're working in partnership with their physician.