Home From The Editor A question of focus

A question of focus

July 2011

Published in the July 2011 issue of Today’s Hospitalist

Can hospitalists do too good a job of caring for their patients efficiently?

A story that covers a presentation made by Eric Howell, MD, chief of hospital medicine at Johns Hopkins Bayview Medical Center, raises that prospect. With so much pressure on hospitalists to improve care delivery, his message should serve as a warning of sorts.

Here’s Dr. Howell’s point: Concepts like forming geographic units can help hospitalists care for patients more efficiently, which in turn can improve throughput and decrease length of stay. But by focusing too narrowly on one part of the hospital, he pointed out, hospitalists can actually undercut their authority throughout the rest of their institution.

Think of it this way: If you focus only on the patients in the one unit where you’re stationed, you’re largely invisible elsewhere. While you might see spectacular results in that unit, you could be limiting your ability to provide leadership hospital-wide.

That’s an interesting concept for hospitalists to keep in mind as they tackle quality improvement projects. With hospitalists under intense pressure to change the way patient care is delivered, it can be all too easy to focus on the problem at hand “to the exclusion of what’s going on in the rest of the hospital.

Hospitalists have rarely been accused of this kind of tunnel vision. The specialty has instead focused on broader initiatives like building a better discharge. (Our cover story is a good example.)

But as hospital medicine continues to mature, it’s entirely possible that physicians may be tempted to move into more narrow areas of focus just to make their jobs more manageable. While that may be a sign of maturity, it seems like there are some instances where it might not be in the best interests of the specialty “or patients.

edoyleEdward Doyle
Editor & Publisher
edoyle@todayshospitalist.com