Published in the December 2010 issue of Today’s Hospitalist
MANY PHYSICIANS ARE LOOKING FORWARD to spending more time with their families this holiday season. But in Las Vegas, where 3 million visitors are expected over Christmas and New Year’s, the holidays are go time for the city’s hospitalists.
According to Darren Swenson, MD, director of medical affairs for the Nevada region of IPC The Hospitalist Company Inc., patient volumes in Las Vegas over the holidays can spike as much as 25%. Because his group’s 38 physicians work in almost every hospital in Las Vegas, that translates to a tremendous increase in patient encounters.
How do they staff up? “We limit the amount of personal time we take off,” Dr. Swenson says. IPC-Nevada hospitalists also work a staffing model of seven days on a week, instead of a more typical Monday through Friday schedule, to make sure the same number of doctors is available every day. And they have several moonlighters ready as back-up.
Most patients with either STD- or alcohol-related problems end up being treated in the ED, although a few intoxicated patients briefly end up on a ventilator. But the biggest group of diagnoses the hospitalists treat over the holidays is respiratory, including upper pneumonias, bronchitis and COPD exacerbations.
“These patients have changed climates, and out here in the desert, it’s dryer and much more windy,” he points out. The No. 2 diagnosis? Gastroenteritis, due to patients eating out “particularly at buffets.
The holidays also bring a surge of patients with chest pain, although Dr. Swenson has yet to treat a patient with chest pain due to winning a jackpot. “Chest pain can be related to anxiety disorders or stress,” he adds. “The holidays can be tough on people emotionally.”
What the hospitalists also treat is a huge influx of patients from Asia and Europe. To overcome language problems, hospitals make extensive use of translation phone services.
When it comes to discharge planning, Dr. Swenson says the hospitalists always give patients copies of their medical records and CDs of images. Most foreign patients have travel insurance, and he’s talked to several travel company medical directors to help them arrange what patients need to fly home.
He’s also discussed discharge plans with doctors as far away as Japan. “I’ve talked to doctors in Switzerland at 10 o’clock at night,” Dr. Swenson says. “It’s amazing how that support network really comes together.”
