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Wednesday, November 19, 2008

Inpatient care and the hospitalist

I am about halfway through my internal medicine rotation which is one of the main required core rotations required for all medical students. I feel like I am getting the hang of how to manage the fairly sick hospitalized patients. There is of course a lot more to learn and master but I feel like I can make sense of what is going on. I am not sure if I would want to have a career as an internal medicine doctor but I like it much more than I thought I would.

Internists usually divide their practice between seeing patients in clinic for routine outpatient issues and then seeing their hospitalized patients in the hospital. Recently many internists have found that the hospital work is not as appealing or as lucrative as outpatient clinic and so many have hired hospitalists to manage their hospitalized patients. A new field is growing in medicine because of this trend. Now there are jobs available as a hospitalist where as an internist you focus only on hospitalized patients. The job consists of seeing hospitalized patients for community internal medicine doctors who no longer want to manage hospitalized patients. 

I have been working as a hospitalists throughout this entire rotation. I am only seeing hospitalized patients who have a community internal medicine doctor as their regular physician. I could actually see doing this as a job. I like the complex cases and there is a great deal of interaction with the patient and their family. It is usually a stressful time for the patient and their family and they are grateful for all the help they can get. So many doctors fail at even elementary forms of communication, that it does not take much to make the family feel comfortable and happy. Simply taking the extra time to explain to them a diagnosis or a test or their given illness brings so much comfort to them that it is rewarding to interact with them and try to help them.

These patients are fairly sick and take quite a bit of intervention to help them recover and in some cases there is no hope for recovery. I find it rewarding to deal with people during these stressful moments. It is easy to connect and have an impact on their lives and often it also has a great impact on my life. Watching someone watch their loved one die is a unique opportunity that one gets as a doctor and much can be learned from these observations. Fortunately in today's world we are often successful and helping the patient return back to health but this is not always the case. This job also makes you ponder your own and your loved ones' mortality. I find myself wondering what it will be like when I die or when one of my close family members die. For some reason i did not think about these things when I was selling mattresses or when I worked at one of my numerous past jobs / careers. Discuss...

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