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The road less traveled

August 2009

Published in the August 2009 issue of Today’s Hospitalist

WHILE THE RANKS OF HOSPITALISTS ARE SWELLING with primary care physicians who decide to chuck their outpatient practice, at least one former hospitalist is choosing to go the opposite route. Earlier this year, Sheryl Okuhara, DO, gave up hospital medicine to move to Bradenton, Fla., and work in primary care.

For four years, Dr. Okuhara worked as a hospitalist at Virtua Memorial Hospital in Mount Holly, N.J. Because she had always planned to return to her home state of Florida, she looked for a job in New Jersey where she wouldn’t have to establish “and then abandon ” a panel of patients. Her husband was finishing a fellowship, and hospital medicine seemed like a perfect fit.

Today, as one of four internists with Bradenton Internal Medicine, Dr. Okuhara has seen first-hand the differences between practicing as a hospitalist and a primary care physician.

“I really enjoy the continuity of care and the relationships you form with patients in the outpatient setting,” she says. “As a hospitalist, it was always difficult to continue a patient’s care.”

Dr. Okuhara still enjoys inpatient medicine and has some hospitalist-like duties. One physician in her practice spends one or two mornings a week in the hospital rounding on all the group’s patients. The experience reminds her of her hospitalist days, but with some major differences.

“I have a good idea about the way the other physicians practice,” she says, “and I know that things will be followed up or taken care of.” Her outpatient practice is integrated with the hospital’s information systems, so “I don’t have to spend 20 minutes looking for a clipboard or a chart trying to find vitals.”

While she’s happy working in primary care, there are challenges. Getting to know the specialists in the hospital is more difficult, and she spends more time playing telephone tag. “It’s hard to get a real sense of who the specialists are,” Dr. Okuhara says. “As a primary care physician, it’s harder to make a connection.”

But probably the biggest difference is patient acuity. “The acuity just isn’t as high as when I was taking call as a hospitalist,” she says.

That’s one reason that Dr. Okuhara doesn’t see herself returning to hospital-only medicine. “There’s so much acuity, you get worn out fast,” she says. “The days were a lot more wearing.”