How do patients pick general surgeons in the hospital? Good question. Most of the time the doctors in the hospital have never met the patient and the patient has never met the doctor. As a hospitalist, any patient who has never been admitted to my hospital will have never met me as their physician.
Most of the time these days, the same can be said of medical subspecialists and even some surgical groups as well. You see, in my city, most primary care physicians have abandoned hospital based medicine. Between the economics of running an office practice and lifestyle issues, many have decided it just doesn't make sense to travel from hospital to hospital seeing in-patients when they could fill their clinic with more insurance paying patients.
As a hospitalist, I have an unlimited patient data base for referral. It's basically everyone. If you need a hospital admission, you're probably going to see me by default. You just don't have a choice. But not so for medical and surgical subspecialists who require a request to see the patient. So how does a medical subspecialist or surgeon get called to see a patient? It's usually at the request of the hospitalist.
When a patient of mine needs a surgeon, I usually ask the patient if they are familiar with any of the doctors in town. I like to give them first crack at who gets to see them. Here's how a recent conversation went:
Happy: You might need a surgeon while you're here. Do you have a preference on a surgeon?Just a little good humor to start your morning. That reminds me, here's a surgeon joke you might appreciate. Oh yeah, I suppose you're also wondering how to hide $100 from a surgeon.
Patient: Just one that finished in the top half of their medical school class
Happy: That's impossible. There are none. We're all internists.
On a more serious note, it used to be patients wanted the best. As you can see, now we're down to the top half. This is good news for the independently practicing nurse practitioner movement. When the general surgeon shortage gets bad enough we'll just train nurse surgeons to fill the necessary gap. At least for the easier cases.
You know, because general surgery isn't that hard, and someone has to do it. At least the easy cases.
