At the Palo Alto Medical Foundation (PAMF), many patients who require hospital treatment have their care coordinated by a "hospitalist," a PAMF physician who works primarily in hospital settings. This system is designed to improve the quality, safety and efficiency of care received by PAMF patients in the hospital.

• What Is a Hospitalist?
• Who Is Treated by Hospitalists?
• The PAMF Hospitalist System
• Hospital Care and Your Primary Care Physician
• Contacting Your Hospitalist

What Is a Hospitalist?

Hospitalists are PAMF physicians typically trained in internal medicine or family practice who specialize in the care of PAMF patients hospitalized at either Stanford University Hospital, or Washington Hospital in Fremont. They provide care for patients requiring hospital treatment with medicine rather than surgery, such as pneumonia, meningitis, gastrointestinal bleeding and chest pain. Hospitalists are familiar with the hospital’s systems, facilities and staff members, and maintain close relationships with specialty physicians such as cardiologists and surgeons.

Hospitalists provide patients with continuity of care, allowing them to see the same physician for much of their hospital stay. Because they work in the hospital, hospitalists can check up on the patient at least once a day and become familiar with the patient’s illness. They can better coordinate care provided by specialty physicians and ancillary departments, such as physical and occupational therapy, respiratory therapy, social services and nursing case management. This dedicated attention helps ensure that the patient receives high-quality care and as short a hospital stay as possible.
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Who Is Treated by Hospitalists?

By virtue of their training, hospitalists generally care for patients with non-neurologic problems that require treatment with medicine rather than surgery. Care for patients with surgical, neurologic, oncologic (cancer) and obstetric/gynecologic conditions is coordinated by specialists in those areas. In addition, although hospitalists are able to treat many cardiac cases, serious problems such as heart attacks are seen by cardiologists. PAMF hospitalists care for adult patients only.
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The PAMF Hospitalist System

The PAMF Hospitalist Department includes seven full-time hospitalists and seven primary care physicians (PCPs) who work as part-time hospitalists. The hospitalists care for adult patients staying at Stanford University Hospital, or Washington Hospital in Fremont.

At Stanford University Hospital, which is a teaching hospital, hospitalists act as attending (supervising) physicians for a team of resident physicians and medical students.

Hospitalists see PAMF patients requiring treatment with medicine, not surgery. The team discusses all aspects of treatment, but the hospitalist is ultimately responsible for the patient's care. At Washington Hospital, hospitalists are the sole care providers as there are no resident physicians.

Most of the physicians who provide consult care to PAMF patients are PAMF physicians. However, some patients with medical conditions in certain clinical specialty areas, such as cardiovascular surgery or orthopedics, may receive care from Stanford faculty or experienced physicians from the community. At Washington Hospital, PAMF relies on the many outstanding specialists in the Fremont community. Because PAMF hospitalists and outside specialists interact frequently in the hospital setting, they are able to develop strong relationships, further improving patient care.

Hospitalists also play a role when PAMF patients come to the hospital through the emergency room (ER). Those patients are seen first by an ER physician, who assesses whether the patient should be admitted to the hospital. If the patient is admitted, the ER physician contacts a PAMF hospitalist, who provides care to the patient either in the emergency room or shortly after admission.

After a patient is discharged, the hospitalist will often see the patient at a follow-up clinic visit within one to two weeks of his or her discharge. This allows the patient to be closely monitored during recuperation and a chance to address issues that may not have been urgent in the hospital. After this one-time visit, patients resume visits with their regular primary care physician.
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Hospital Care and Your Primary Care Physician

Although PCPs do not treat patients while they are in the hospital, they remain in regular contact with the hospitalist from the time the patient is admitted into the hospital to discharge. The hospitalist provides the PCP with frequent updates regarding the patient's diagnosis, condition, test results and treatment plan, and the PCP can provide the hospitalist with the patient's medical history. Pertinent medical information is shared between PAMF physicians through the patient's electronic health record.
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Contacting Your Hospitalist

Hospitalists generally visit the patient once a day or more as necessary during the duration of the hospital stay. At any of these visits, hospitalists are happy to answer questions from patients or family members. For urgent questions during the day or after hours, a patient's hospitalist may be reached at 650-321-4121 via PAMF's operator. A hospitalist is always on call after hours to offer advice or assistance.

Patients may not see the same physician on the weekend as during the week. At Stanford University Hospital, care may be transferred to another hospitalist. However, patients at Washington Hospital are seen by a PCP from PAMF's Fremont Center. Generally, patients will not receive care from more than two hospitalists during their hospital stay. If two hospitalists must provide care for one patient, the physicians discuss the patient's condition and background in detail beforehand, and the patient and family are notified of the change.

Palo Alto Center
795 El Camino Real
Palo Alto, CA 94301
650-321-4121

Fremont Center
3200 Kearney Street
Fremont, CA 94538
510-490-1222

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