Unless you are a teenager, you may remember the days when your doctor came to see you in the hospital.  It was called “making rounds.”  And this was how it worked:  The doctor decided that your condition (pneumonia, sepsis, etc.) warranted admission to the hospital where he had privileges.   That night, and every day thereafter, he, she,  or their associate, would stop by in the evening to see how you were doing.  That was very comforting, especially if you had been that doctor’s patient for many years.  But that’s not how it works anymore.  Warning! Your doctor may ghost you.

Here’s what likely to happen now:  You call the doctor’s office during a medical emergency, and they recommend that you go to the Emergency Room immediately.  You call 911, and the EMT’s  ask which hospital you would like to go to.  Naturally, you pick the one where your doctor has privileges.  Otherwise, you would be under the care of a stranger who knew nothing about you.

You spend some time in the Emergency Room undergoing a series of tests, based on your condition or reason for being there.  Eventually—maybe a day later—they find you a room and you are formally admitted to the hospital.  After all the worry and excitement begins to settle down, you relax.  No doubt, you will see your doctor when he makes rounds this evening.  Unfortunately, that isn’t going to happen.

A stranger enters your room and announces himself as the hospital doctor.  He will be managing your care from now on.  Over the course of your stay, you will meet several specialists who have been called in to find out what’s wrong with you.  You may be visited by a cardiologist, nephrologist, urologist or any other type of physician.  Some technicians may come to your room to perform tests at any hour of the day or night.

On the other hand, you may be wheeled down the hall to have a cat scan or chest x-ray.  All of it comes as a surprise.  You keep wondering when your primary care physician is going to show up and explain what’s happening. What you don’t know, and will soon learn, is that you’re not going to see him at all. Warning! Your doctor may ghost you.

In the last decade or so, busy  primary care physicians have  turned the care of their hospitalized patients over to HOSPITALISTS.  The American Board of Physician Specialists defines hospitalists as “…physicians who have dedicated their careers to hospitalized patients.” Simply put, hospitalists are medical specialists who most often earn a residency in internal medicine and are certified in hospital medicine. While hospitalists confine their practice within a hospital setting, they often specialize in non-medical issues that are relevant to their field of study. That said, if you have been seen by a doctor in a hospital, safe to assume he might have been a hospitalist.”

Now, then.  What if the hospital physical therapists decide you should go to a rehab facility before going home?  Once again, all ties with the hospitalists who have been treating you will be severed.

In the rehab facility, you will once again be under the care of that facilities’ Hospital Doctor.  You may or may not ever see him or her, but they will plan your treatment and care.  At that point, things may fall through the cracks. As an example,  they may be short staffed, and not answer your call button promptly when you have an emergency. Meanwhile, your trusted primary care physician has no idea what is going on.  Warning! Your doctor may ghost you..