Hospitalist evolution? "Extensivist" = hospitalist who prevents readmissions by seeing patients after discharge

"On a typical morning, Sandip Patel, MD, a hospitalist employed by a health plan in Southern California, rounds on patients at the hospital, then meets with case managers and a medical director to review care plans and decide which patients will stay or go.

In the afternoon, Dr. Patel may see recently discharged patients—those coded "red" or "yellow," based on medical complexity—at an integrated-care center, which is also owned and run by the health plan. Then he might head to a nursing home to check on patients discharged a week ago.

Dr. Patel considers himself an "extensivist" with a goal to reduce readmissions. "Lowering readmission rates is within the purview of the hospitalists."

Health-plan hospitalists cut readmissions—by sometimes leaving the hospital. Today's Hospitalist, 2010.
Median adult hospitalist compensation up slightly to $220,619 in 2010
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  1. Sounds more like a devolution back to an internist that rounds in the hospital. Patients need a medical home and better care coordination not a hospitalist stepping on a primary care physician's toes. If the patient doesn't have a PCP then that problem needs to be solved. Further, the nursing home patients should already have a physican that sees them. I applaud any doctor taking time to see patients outside of their normal domain, but I don' think this is a model system that needs to be replicated.

  2. The whole system is still evolving at rapid pace.