96 | Drs. Sean and Adam | EM vs IM | Admitting the weak elderly patient | Workflow as a hospitalist | Consulting a hospitalist

EM and IM physicians don’t get a great insight into each other’s careers in medical school or in residency

Do hospitalists like doing consults as opposed to just taking admission requests?

Sean says, yes, because it gives us an opportunity to solve problems together. They want to be consulted as much as possible 

Admissions would be greatly decreased if there was more robust outpatient follow up ability but various factors make this difficult 

Sometimes a slight delay in coordinating with the hospitalist or social work etc can save an admission and therefore free up ER beds down the line 

Not every conversation with the IM physician must be an admission request

When they are consulted, the expectation is that they put in a consultation note and see the patient

Looking at an admission as trying to “sell” something is the wrong way to look at it. If you have a clear story and objective data, you should be able to articulate why they need admission most of the time

What does the day look like for a hospitalist?

Admissions for our team are very easy early in the morning but rapidly ramp up during the afternoon

The admitting physician handles ER admissions, outside transfer direct admissions and ICU transfers to floor beds

Sean goes into some detail about the workflow and what his day looks like

What are the difficult admissions to handle?

We talk about one of the most difficult admissions we commonly see: An elderly patient with weakness, unable to walk but no acute findings

We talk through possible solutions to better care for these difficult cases