Justin Morgan, MDThe next time your child needs to be in the hospital, you may encounter a unique type of medical provider, a pediatric hospitalist. This is usually a pediatrician who specializes in the medical care of hospitalized pediatric patients. There’s an evolving trend toward care (for both adults and children) of hospitalized patients by inpatient hospitalists, perhaps due to the added convenience for primary care providers and their patients, greater efficiency and reduced length of stay in the hospital, increased patient safety and more cost-effectiveness.

How are pediatric hospitalists trained?

Most pediatric hospitalists are board-certified pediatricians who have undergone the same training as other pediatricians including four years of medical school and three years of a general pediatric residency. The only difference from most other pediatricians is hospitalists spend a majority of their time within the walls of the hospital and do not have their own panel of patients they see in an outpatient setting.

What do pediatric hospitalists do?

Pediatric hospitalists treat a wide variety of illnesses and disease processes, both common and rare. Some hospitalists see newborns and attend deliveries, while others do not. Most will provide consultation and admit patients from the emergency room. Hospitalists do not have an “office” per se. Once patients are admitted, the pediatric hospitalist takes full responsibility for their care for the entirety of the hospital stay. After hospital discharge, care reverts back to the patient’s primary pediatrician.

What are the advantages of having pediatric hospitalists?

Hospitalists generally have more expertise in caring for complicated hospitalized patients on a daily basis. They are more available throughout the day (and in many hospitals, they are on-site 24/7) to meet with family members, follow-up on tests, answer questions and deal with problems that may arise. A pediatric hospitalist may need to see a patient several times through the course of a day. Because hospitalists are based within the hospital, they are able to track test results and order necessary follow-up promptly. A typical pediatrician who also has a busy office practice may not have the availability to coordinate patient care as quickly or round more than once a day. Pediatric hospitalists communicate with other doctors caring for the patient as well as the referring or primary care pediatrician. Many pediatricians actually prefer hospitalists taking care of their patients.

What are the disadvantages of having pediatric hospitalists?

The main disadvantage of having a hospitalist take care of your child in the hospital is that the hospitalist may not know your child’s detailed medical history as well as your primary pediatrician. If the hospital’s electronic health record (EHR) is not compatible, prior medical record details could be challenging to access. However, most pediatric hospitalists will communicate with the primary pediatrician regarding significant changes in your child’s condition and at least at hospital discharge. When a patient who was recently hospitalized returns to the pediatrician’s office for follow-up, the pediatrician should have a discharge summary from the hospitalist available for review.

Takeaways:

  1. Pediatric hospitalists are usually board-certified pediatricians who specialize in caring for pediatric patients while they are in the hospital.
  2. Only providing care for hospitalized pediatric patients is the focus of a pediatric hospitalist.
  3. Pediatric hospitalists are available in a timely manner to discuss issues with family members, arrange for prompt follow-up and coordinate care with other providers.
  4. The pediatric hospitalist communicates with the child’s pediatrician regarding details of the hospitalization and necessary follow-up care after discharge.

Resources:

  1. Definition of a Hospitalist and Hospitalist Medicine. Society of Hospital Medicine. Accessed May 25, 2015.
  2. Wachter RM, Goldman L. The emerging role of “hospitalists” in the American health care system. N Engl J Med.1996;335 :514– 517.
  3. What is a Pediatric Hospitalist? from the American Academy of Pediatrics. Accessed May 25, 2015.
What is a pediatric hospitalist?

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