A pilot program to introduce the hospitalist system is making slow progress because of the low application rate of specialists, but hospitals continue to challenge to improve the quality of healthcare through specialized treatments of in-patients.
Some hospitals do not just place wanted ads and wait for applicants but run around to find out “comrades” willing to work together for the successful implementation of the new system, explaining them about their operational principles and offering visions.
A case in point is Yonsei Cancer Center연세암병원, which opened its surgical hospitalist ward on June 13. Its latest accomplishments include the hiring of two medical residents – who had been guaranteed associate professorship by Konkuk University Hospital and Dongkuk University Hospital, respectively -- as hospitalists.
It was not without some difficulties that Yonsei Cancer Center opened the hospitalist surgical ward. In a situation where application fell far short of expectations, it was pretty much of a challenge to prepare for the hospitalist system to be run as a team.
Moreover, it suffered the pain of failing to be included in the first batch of institutions to conduct the pilot project, by the Ministry of Health and Welfare (MOHW)보건복지부.
However, it employed three surgical hospitalists exclusively responsible for the treatment of in-patients in May and started to operate the ward on June 13.
|Yonsei Cancer Center has been operating the hospitalist surgical ward since June 13.|
Korea Biomedical Review met with Lee Kang-young이강영, head of Optimal Treatment Management Office at Severance Hospital, to hear from her how they hired hospitalists and operate the ward.
“The hospitalization of patients means they require real-time treatments. When we looked back whether we were providing them with real-time treatment, however, there was so much to be desired,” Lee said. “If there are people exclusively taking care of patients with the introduction of the hospitalist system, we could improve treatments’ quality, and this is why introduced it.”
Asked how they employed hospitalists, Lee said the hospital at first sought to hire five or more hospitalists but experienced difficulties as there were few applicants.
“But we could not just sit idle. We checked each specialist who received the training at Severance Hospital and what were they were doing. Then we found out appropriate targets and called each of them to explain about the ward’s operational principles of the hospitalist system and sounded out their intention,” he said.
“Self-satisfaction is most important for hospitalists. Only when the doctors are satisfied with themselves, they can upgrade service quality and make a relationship with people better to bring about results satisfactory to all,” Lee said. “We had no other choices but to work hard to employ appropriate doctors for the early establishment of the system.”
The ward did not reach for them just to fill the application quota. It offered a clear vision to Severance hospitalists that they are like family members who will go together toward the same goal.
About the uncertain future cited by many medical specialists as the reason for avoiding to become hospitalists, Lee said he believed time would solve it.
Noting that the U.S. hospitalists have established their professional domains, Lee said the system would soon take its place as a professional field in Korea, through which much of future uncertainty will be solved.
“Yonsei Cancer Center could open the hospitalist surgical ward and enter into its normal operation because all of its members discussed how to proceed with it rather than leaving the job to one leader,” Lee said. “All members are interested in hospitalist system and root for it. It would be strange if it will not succeed.
Why did they become hospitalists?
|Jung Eun-joo, a hospitalist surgeon at Yonsei Cancer Center, says the hospitalist system will make up for the weakness of the Korean medical system, in an interview with Korea Biomedical Review Monday.|
Jung Eun-joo정은주 is the specialist who has just begun to work at hospitalist surgical ward of Yonsei Cancer Center, throwing away the associate professorship at Konkuk University Hospital.
“I had personal interests in in the hospitalist system,” Jung said. “Korea’s healthcare system has attained spectacular development but still has many weaknesses, but the hospitalist system can supplement it, and this is why I applied for it.”
“Of course, the hospitalist system is still a pilot project and has various uncertain elements about the future,” she said. “If we complement such weaknesses one by one, however, the system will play a vital role in creating a new paradigm of healthcare.”
She also pointed out there has been a problem in setting the role of surgeons, contending the hospitalist system could be the solution to it.
“The surgeon’s role is to treat and operate patients, and after the operation, manage them and sent them back home in a healthy state,” Jung said. “It is true, however, Korean surgeons have focused on the operation. It is not unusual doctors cannot see the patients they operated even just once a day.”
“It is desirable a hospital should work by the team for the sake of patients’ safety,” Jung went on to say. “We should seek high-quality treatments of in-patients by making doctors good at surgery operate on patients while leaving the “care part” to doctors who are good at taking care of post-operation patients.”
Jung noted that the hospitalist system is not just for filling the treatment vacuum with the implementation of the Special Law on Medical Residents. However, she said, it is true the system is interlocked with the 80-hour-a-week work system for residents and is the only system that can ensure both the 80-hour workweek and patient safety.
Lastly, she told her junior doctors, “The hospitalist system is the first step toward changing Korea’ medical system. I would like to tell you that it would grow into a significant occupational group worthy of a challenge.”
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