Sept. 02--Wedgewood Family Practice and Psychiatry Associates will stop seeing patients at local hospitals effective Oct. 1 and will instead focus their efforts on inoffice care.
Many local doctors' offices have started relying on hospitalists -- physicians who work solely in a hospital -- to treat their patients when they are admitted, rather than doing rounds at the hospitals themselves. Some doctors use hospitalists all the time or just for night or weekend hours so they don't have to be on call.
Wedgewood, with locations in Suncrest and Westover, announced the change in a letter sent to patients, a newspaper advertisement and a press release. Patients who need hospital care will be treated by hospitalists at Monongalia General Hospital, while Wedgewood physicians will follow up with patients upon their hospital discharge.
"For better than a decade now, the trend in health care has been for primary care physicians to become fully office-based to meet the increasing needs for medical care of an aging population," the release explained. "This movement resulted in the advent of doctors who specialized in the care of patients in the hospital, or 'hospitalists' as they are now known."
Mon General spokesman Greg Kealey said hospitalists are inpatient medicine specialists who only practice in hospitals. They know the inner workings of the hospital, communicate with private physicians and relieve other physicians from having on-call responsibilities, which allows them to be more attentive to their in-office patients, Kealey said. They also care for patients who don't have regular physicians.
According to the Society of Hospital Medicine, the hospitalist speciality began in 1996 and now includes more than 30,000 doctors across the country.
"Since then, the field has basically exploded," spokeswoman Jacqui Petock said.
Petock said hospitalists more frequently deal with acutely ill people than private practice doctors.
"Instead of seeing a primary care physician who might see pneu- monia once a year in the hospital, your hospitalist might see it 20 times a week," she said.
Kealey said hospitalists have been used at Mon General for six years, although private practice physicians still have privileges at Mon General.
"Hospital privileges are basically the authority granted by the governing body of a hospital to a physician who wants to practice at their hospital," Linda Ollis, Mon General chief operating officer, said. "The physician will request privileges that include basic activities like admitting their patients to the hospital, ordering lab tests, medications and other diagnostic test or performing surgery."
Private practice physicians bill their patients for the services it provides and the hospital bills the patients for what they provide, a local doctor explained. Hospital privileges do not cost the private practice doctor anything. Not practicing at a hospital does not reduce malpractice premiums, according to Deborah Wilkins, Wedgewood spokeswoman.
Darryl Duncan, president and CEO of Mon Health System, said in an emailed statement that 70 percent of hospitals Mon General's size or larger use hospitalists.
"The hospital-based medicine practice is being driven by the pressures on the healthcare system and will likely continue to grow as our healthcare system attempts to adapt to healthcare reform," Duncan said.
The doctors' side
Dr. Roger Abrahams of Morgantown Pulmonary Associates said they have used hospitalists on nights and weekends for about a year.
"They're a godsend," Abrahams explained. "What it's done is really let us have a life. Before we were on call every other weekend and every other night. It really gave us no time for family. I'd miss family events because I was on call."
Abrahams said his patients are getting used to the idea. They've run into some kinks when he isn't notified that his patient was admitted unexpectedly to the hospital and the patient wonders why he didn't come to see them.
Dr. Brian Hawthorne, of Lakeside Family Practice, said they use hospitalists only during the night. He makes daily rounds to his patients during regular business hours.
In the past, Hawthorne said they split on-call duties with Wedgewood physicians.
"We are still getting help from hospitalists, but we are actively involved with patients and see them everyday," Hawthorne said. "Patients are comfortable knowing their doctor will be in in the morning."
Hawthorne said getting a good night's rest helps him do his job.
"It gives us more time in the office and we're a lot less tired and less grumpy," he said.
Dr. Indira Majumder, a Morgantown pediatrician, said she spent three-quarters of her day in the hospital until she decided to stop seeing admitted patients three years ago. She said she hasn't had any complaints from patients.
Angie Foy, office manager of Total Family Care in Kingwood, said doctors there still treat their patients in the hospital. They rotate weekends with other area physicians.
Ed Stockett, 86, of Morgantown, said his doctor will still visit him in the hospital.
"I think any doctor you go to, when you go to the hospital and he doesn't come to see you, I don't think much of him," Stockett said.
Katheryn Stimmel, 81, of Morgantown, doesn't like the idea either.
"I would rather they did [come to the hospital]," Stimmel said. "I can't get used to the doctor sending you to the hospital and you don't know who you are getting."
Wedgewood officials said they "wrestled" with the decision to stop seeing patients at the hospital, but decided it was in the best interest of their patients.
WVU Hospitals spokeswoman Amy Johns said their hospital uses physicians who are also School of Medicine faculty. Some of those are hospitalists, by speciality, and spend more time treating patients in the hospital and less time treating out-patients in clinics, Johns said. Outside doctors do not have hospital privileges.
At Preston Memorial Hospital, spokeswoman Kim Colebank said they are exploring employing hospitalists, but currently rotate doctors who work for the hospital with community doctors for patient rounds. Generally, she said, the patient's regular doctor will come. PMH is a small, critical access hospital with 25 or fewer beds, Colebank said.
Fairmont General Hospital uses hospitalists, but still grants privileges to private practice physicians, spokeswoman Dawn Metzgar said.
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