Medical hospitalists typically manage hospitalized patients. However hospital medicine is evolving to meet the changing demands of hospitals and communities. A recent innovation, surgical comanagement is now part of the standard repertoire of most medical hospitalist groups. We describe a further hospitalist innovation where a medical hospitalist physician assistant with advanced surgical training provides surgical first assistant services to surgeons.
To provide tertiary care in a community setting whereby a medical hospitalist physician assistant highly trained in surgical first assisting operates with surgeons who would otherwise move their patients to tertiary care settings.
Our group employs medical hospitalist physician assistants who are highly trained in surgical first assisting for the following specialties: thoracic, gynecologic oncology, and micro vascular surgical reconstruction. The physician assistant first assists in the operating room and then performs the medical consultation in collaboration with the oncall physician medical hospitalist. The patient is then followed by the medical hospitalist service during their inpatient stay under a comanagement model. Professional fees for surgical first assisting by physician assistants are reimbursable at a percentage of the physician rate by most federal programs, insurance carries and workers’ compensation programs. Patient satisfaction and financial viability of this model of hospital care are presented.
A medical physician assistant trained in first assisting in surgery is beneficial to the health system, operating surgeon and patients. This innovation in hospital medicine is also financially viable. The hospital benefits because surgeons of different subspecialties operating at different facilities keep patients in the community setting rather than treating them in a tertiary care setting. Patient and family satisfaction increases while surgical revenue for the hospital increases. The surgical subspecialist who operates at different facilities has a known core provider group (the physician assistant and medical hospitalist group) to provide intraoperative first assistance and to support perioperative and postoperative management. Surgeons in this situation are often faced with the challenges of learning different electronic medical record systems. A dedicated hospital support team eases this challenge. Surgeon satisfaction has increased as demonstrated by requests to expand this service to additional operating surgeons and by current surgical subspecialists increasing surgical volumes at the hospital.
To cite this abstract:Mitchell D, Riekers W. Medical Hospitalist Physician Assistant with Advanced Surgical Training. Abstract published at Hospital Medicine 2012, April 1-4, San Diego, Calif. Abstract 97758. Journal of Hospital Medicine. 2012; 7 (suppl 2). https://www.shmabstracts.com/abstract/medical-hospitalist-physician-assistant-with-advanced-surgical-training/. Accessed April 4, 2020.