Thursday, March 5, 2020

How hospitalists fit into cancer care


BY DEVON CARTER October 23, 2018
Being admitted to the hospital for complications related to cancer or your treatment can be scary and stressful. But hospitalists will help you during your stay.
These specialized members of the medical team often have a background in internal medicine but they’re specialized in order to coordinate care seamlessly and help patients navigate through their time at the hospital.
To understand the role our hospitalists play in a patient’s cancer treatment and care, we spoke with Marina George, M.D. Here’s what patients and caregivers should know.
What does a hospitalist do?
The hospitalist is your attending physician while you’re in the hospital. Our job is to synchronize all of your care — including diagnose you, treat you, help you recover — and make your hospital stay as smooth as possible. When our patients check into our hospital, they aren’t just coming with cancer – they have an entire medical history that we take into consideration, such as diabetes, heart disease or arthritis. The hospitalist coordinates your regular clinic or outpatient care team – such as your radiation oncologist, surgeon and/or medical oncologist – and also your inpatient care team, such as nurses and any specialists you may need to see. And we care for you during your entire hospital stay, from when you walk through the door to when you’re discharged. Our goal is to getting you recovered, out of the hospital and back to your cancer treatment in an outpatient setting as quickly and safely as possible.
How do hospitalists coordinate care?
We’re your medical voice. Patients don’t always know the questions to ask to have an informed, meaningful discussion with their care team. But as hospitalists, we have the medical knowledge and the time to spend with you to help you fully understand the situation and your options, so you can make a confident choice about your care.
For example, if you’re on chemotherapy, but come to the hospital because your tumor has grown and now obstructs your bowel, I’ll coordinate with your medical oncologist as well as a surgeon. I’ll hear the risks and benefits of a surgical intervention, and then meet with your medical oncologist to gather his or her recommendation. I’ll then bring all options to you, explain the pros and cons, and help you make a choice that’s in line with your values and wishes.
Hospitalists also help coordinate communication with your family. If necessary, we hold family meetings with you and your caregivers to ensure everyone is on the same page about your care.
What questions should I ask my hospitalists?
It’s your time to ask anything. I tell my patients to ask me all the questions they’ve always wanted to ask, but haven’t had the chance or didn’t feel comfortable. You’ll have the time to think about things while you’re in the hospital, and I have the time to answer your questions or find you the answer.
Most importantly, don’t be afraid to ask questions. That’s what I’m here for.
Does it complicate things if I’m enrolled a clinical trial?
No. We take care of patients on clinical trials exactly the same way we care for patients who aren’t. We’ll let the principal investigator of the trial know you’ve hit a road bump in your care and have been admitted to the hospital, but our goals are still the same – to get you recovered and back to your cancer treatment.
What’s your advice for a patient who’s going to be hospitalized?
The first thing you should do is ask for the name of your hospitalist. You want to make sure you know who is in charge of your care so that you remain informed and confident in what’s going on. When you meet your hospitalist, ask that individual to explain the status of your care in detail. Ask them to explain your care plan for the hospital stay and what medications you’ll be on. Then you can start planning together what support you’ll need once you’re home, such as home care, medical equipment or therapy.
Second, bring all of your medications with you to the hospital. We can work together to organize things and potentially consolidate what you’re taking.
Is there anything else you want patients to know about hospitalists?
Know that we’re on your side. Your hospitalist is your advocate. We’re going to communicate with the rest of your care team about your goals and priorities while we coordinate your medical care. We will act in your best interest.

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