Published in the January 2004 issue of Today’s Hospitalist
While patients are gradually adjusting to the idea of hospitalists, not their physician, providing their inpatient care, the notion can be particularly jarring for the parents of sick children. Some actually feel that their longtime pediatrician is abandoning them at a critical juncture in their children’s lives.
To help parents overcome that sense of anxiety, a group of pediatric hospitalists in Orlando, Fla., has come up with an easy solution. Every time the six hospitalists from Nemours Children’s Clinic-Orlando or the group’s rounding nurses see a new patient, they give the parents a one-page information sheet featuring photos and short biographies of all the doctors. The page also explains the hospitalist program and the role of inpatient physicians.
“The information sheet makes our service a little more personal, so the family feels like there is a real person seeing their child,” explains division chief Ira Pinnelas, MD, a founding member of the group. “Nobody asked us to do this, but it has been a nice way to provide customer service and give our group some credibility.”
“Patients and their parents can see we are all board-certified and that we trained at good programs,” he adds. “It gives patients some comfort to read their doctor’s biography, and it makes us seem a little more warm and fuzzy.”
Dr. Pinnelas says the photo sheet also comes in handy as a marketing tool for the practice. Pediatricians in the community who regularly refer their patients to the group’s hospitalists keep copies in their offices. They can give the sheet to a sick child’s parents while the doctor is on the phone arranging a hospital admission.
“The outpatient doctor can tell the mom, ‘Here’s Dr. Pinnelas and a description of his service. He will be caring for your child at the hospital. I have known him for 10 years,’ ” Dr. Pinnelas says. “It helps the outpatient doctor, who in many parents’ mind is almost abandoning their child.”
The hospitalists have found that the photo sheet offers another benefit: They no longer have to spend the first 10 to 15 minutes of patient visits “doing damage control and explaining who we are and why their pediatrician isn’t seeing them in the hospital,” Dr. Pinnelas explains.
After all, he adds, most people who come to the hospital still aren’t well-informed about hospitalists. “This way,” he says, “there is no confusion about who is caring for the child.”
The nurses also use the information sheet to explain to new mothers that a doctor from the group has already seen her newborn “even though she may not have been awake enough at the time to remember the physician clearly. “Putting a face with a name makes the experience more personal,” Dr. Pinnelas says. “Parents want to remember who cared for their child.”
The information sheet is just one of several strategies the group has used to successfully grow its practice. Since beginning in 1999 with two hospitalists, the program has grown to six full-time physicians.
The group is a private practice owned by the Nemours Children’s Foundation, which operates a hospital in Delaware and several large children’s clinics in Delaware and Florida. Hospitalists at Nemours Children’s Clinic-Orlando treat sick children and well newborns at two hospitals on one campus.
At Arnold Palmer Hospital for Children & Women, a large teaching hospital, these hospitalists oversee housestaff on the pediatric medical wards. Orlando Regional Lucerne Hospital is a nearby community hospital with a small pediatric unit that accepts only low-acuity patients, Dr. Pinnelas explains.
While the photo sheet has helped improve the hospitalists’ relationship with patients, the group uses another tool “an admission beeper “to help make the lives of referring pediatricians in outpatient practices easier.
The hospitalist responsible for admissions that day wears the beeper day and night. Pediatricians in the community can call and be assured that a hospitalist “not an answering service or a nurse “will call them back, typically within five minutes.
Dr. Pinnelas says he started using the admission beeper on day 1 of the practice four years ago. While working as a community-based pediatrician, he used to be frustrated when trying to reach someone expeditiously who could take care of admitting his patients.
“With this,” he explains, “the practicing pediatrician who has a sick kid in his office can reach somebody right away who is going to get the ball rolling to get that kid out of his office.”
Taking care of his fellow hospitalists “hiring the right people and designing schedules that allow them to have a life outside of work “is another key to the group’s success, Dr. Pinnelas explains. The group’s schedule is designed to require only one hospitalist to work hard all weekend. Two other inpatient physicians work a little on the weekends, but they usually can be home by noon.
There are no hospitalists in house overnight. Instead, the group depends on housestaff to care for its patients during those hours.
“I can’t burn out my hospitalists,” he says. “We think about that all the time. We work hard when we are at the hospital, but when we are not there, we can have a life. That’s why we don’t lose pediatricians, and I intend to keep it that way.”