Hospitalists Should Join CALTCM!

At a recent meeting of a local hospital with its SNF partners, a hospitalist made an appeal for SNFs to remove peripherally inserted central catheters (PICC) lines and Foley catheters when they were no longer necessary, since hospitalists were seeing this as a potential cause of readmissions.  After the meeting, we chatted and I discovered he was a Medical Director of a SNF, a member of CALTCM, and had signed up for the AMDA Foundation’s “Futures” program that will meet in San Antonio in March 2024.  I wish that I could have “bottled” his passion for high-quality medical care in SNFs.

In my community, we only have a few private internists and family physicians caring for patients in SNFs.  SNFs struggle to attract providers and providers may feel compelled to care for more patients than they can optimally manage.  With so few providers, vacation coverage is hard to find and is very stressful for those providing the coverage.  A few bright spots have emerged from hospitalists stepping into positions in our setting.  By pursuing education through CALTCM and AMDA, The Society for Post-Acute and Long-Term Care Medicine, they quickly adapt their skills and expertise and can be very effective providers.  For those becoming Medical Directors, AMDA offers a wonderful certification course that provides a comprehensive foundation for improving population health and achieving beneficial outcomes in the PALTC setting.  Our state has wisely chosen to mandate this certification to those who are entrusted to become Medical Directors.  HSAG has created a wonderful summary regarding this requirement at:  This mandate requires certification within 3 years of becoming a SNF Medical Director.

As hospital foundations and SNFs take on greater financial risk together, the advantages of greater integrated care are significant.  If their hospitalists were to take on roles as Medical Directors and attending physicians for their SNF partners, costly readmissions would decline, and care could become much more efficient.  If SNF partners used EPIC, SNF providers could focus less on charting and more on patient care.  Discharge summaries in EPIC would be available for downstream providers and foundation leadership could analyze data across SNF partners to identify opportunities for improvement.

This vision for the future of health care in your communities may well be advanced by people within the hospitalist community.  I believe joining CALTCM is an important next step.

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Comments on "Hospitalists Should Join CALTCM!"

Comments 0-5 of 1

- Friday, December 15, 2023

Certainly from a medical management perspective, making good use of the broad skill set that comes from being a hospitalist makes sense. Where it falls short, however, is in the patient/resident care aspect. As a psychologist who provided services in SNFs all over the North Bay, I offer the anecdotal observation that those receiving care don't have a clue about who is Medical Director or who is making medical decisions. This gap contributes to resident's reluctance to complain or share symptoms of discomfort, decline, and/or outright pain. There needs to be both a top-down and bottom-up approach to management of chronic issues, including the psychological impact of feelings of helplessness and hopelessness.

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