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Hospitalists make ER process easier

Eileen JoyceHospitalist Dr. Cassandra Loo listens to Ron Williams' breathing sounds at Sierra Nevada Memorial Hospital Tuesday.
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If Elliott Metcalfe has his way, visits to patients by primary care physicians at Sierra Nevada Memorial Hospital may become a thing of the past.

An internal medicine specialist, Metcalfe is one of five SNMH physicians responsible for performing inpatient duties within the hospital.

Metcalfe is a hospitalist, charged with ordering tests and procedures, admitting patients, and directing their care during their hospital stay.



Each hospitalist works with the patient’s primary care physician, offering a seamless transition between a patient’s hospital stay and visits to his or her personal doctor’s office.

“For the patient, it should make them more comfortable, knowing that the doctor they have is specializing in inpatient care,” said Metcalfe, one of Sierra Nevada Memorial’s first two hospitalists.




The hospital has long wanted such a program for inpatient care, spokeswoman Brett Nelson said.

The program began two years ago and grew to five doctors in September. Two hospitalists are present at the hospital every day.

Metcalfe said the program frees time for the primary care physician’s outpatient practice and reduces response time for medical procedures.

“Doctors can concentrate on what they do best, which is outpatient care.”

There is no cost incurred by the hospital for the hospitalists, who, like other physicians working at the facility, are not SNMH employees.

The trend to use hospitalists is a relatively new one, but is gaining popularity. According to the National Association of Inpatient Physicians, there are approximately 6,000 hospitalists working in the United States, up from 2,000 four years ago and several hundred when the 1990s began.

The Journal of the American Medical Association suggests the specialty reduces the length of a hospital stay and helps cut costs.

As an example, Metcalfe said, hospitalists can admit patients from the emergency room to the hospital without waiting for the patient’s primary care doctor, thereby freeing up space in SNMH’s crowded ER faster.

“The addition of the hospitalist program has been a lifesaver for our department,” said Darren Phelan, medical director of SNMH’s Emergency Department.

“They’re readily accessible in the hospital and not pulling doctors away from their practices,” Phelan said. “We’re very grateful for them.”

Miners Community Clinic relies on hospitalists to expedite its patients’ hospital stays, Nelson said.

Metcalfe sees hospitalists becoming the norm, not the exception, in the evolution of care.

“It takes Sierra Nevada Memorial Hospital out of the rural hospital arena and makes us more in line with big-city care.”


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