Although surgical comanagement is a rapidly expanding role for hospitalists, the growing challenge is to create a clinical experience that is rewarding to hospitalists long term particularly in academic medical centers.
To implement a hospitalist comanagement teaching service for orthopedic surgery residents focused on the medical care of orthopedic patients.
During 6 months of the academic calendar, a teaching service has been created by pairing 1 orthopedic surgical intern with a senior staff hospitalist who functions as the orthopedic comanagement physician for the orthopedic joint replacement service at a large, urban academic medical center. The primary educational goal of the monthlong rotation is for the resident to acquire the experience to become familiar with managing the medical care of orthopedic patients with common chronic medical conditions or medical complications related to the perioperative period. Topics taught by hospitalist faculty include cardiac, pulmonary, and venous thromboembolic risk stratification; management of hypertension and diabetes mellitus; and recognition/management of acute venous thromboembolic disease, acute myocardial ischemia, sepsis, and postoperative delirium. These topics are typically covered by direct bedside instruction in the care of actual patients and by review of pertinent literature, Additional learning objectives are achieved covering the Accreditation Council for Graduate Medical (ACGME) general competencies, such as the physician's role in patient/family communication, team collaboration, and quality improvement. Finally, as orthopedic residents serve in their role as the “orthopedic internist”, they are educated about the proper role of comanaging hospitalists. The service typically has a census of 10–20 patients weekly and contains patients with various acute and chronic medical conditions. Orthopedic residents are fully committed to the service and are primarily responsible only for the medical care of their patients on the surgical service under the constant supervision of hospitalist faculty.
This novel hospitalist comanagement teaching service has become an integral part of the orthopedic residency program, and fulfills the ACGME Orthopedic Surgery Residency Review Committee requirements for internal medicine training, while delivering educational content that is relevant to surgical residents on surgical patients. Orthopedic surgery residents and staff have viewed this new experience as a significant improvement from orthopedic residents serving as rotating residents on the internal medicine service because of the timely and focused learning opportunities. In addition, the academic involvement has made the comanagement service a more stimulating activity for hospitalist faculty. Future plans include continued evaluation of orthopedic surgery resident/staff and hospitalist satisfaction as well as possible expansion to other surgical services such as neurosurgery.
P. Watson, none; Z. Kalynych, none; K. Caverzagie, none; T. Parsons, none.
To cite this abstract:Watson P, Caverzagie K, Kalynych Z, Parsons T. The Comanagement Teaching Physician: A Promising New Role for the Hospitalist on the Academic Surgical Service. Abstract published at Hospital Medicine 2009, May 14-17, Chicago, Ill. Abstract 133. Journal of Hospital Medicine. 2009; 4 (suppl 1). https://www.shmabstracts.com/abstract/the-comanagement-teaching-physician-a-promising-new-role-for-the-hospitalist-on-the-academic-surgical-service/. Accessed January 23, 2020.