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Hospitalists enter specialties

Dr. James Griffith is the first gastroenterologist at Phoebe Putney with the subspecialty of hospitalist. 
Griffith attends only hospital inpatients in his specialty and says it helps both outpatient physicians and patients in and out of the hospital.

Dr. James Griffith is the first gastroenterologist at Phoebe Putney with the subspecialty of hospitalist. Griffith attends only hospital inpatients in his specialty and says it helps both outpatient physicians and patients in and out of the hospital.

ALBANY -- Phoebe Putney Memorial Hospital has had hospitalists -- doctors who only see patients who have been admitted to the hospital -- for some time. Dr. James Griffith, however, added a new wrinkle to that when he came on board in January.

Before Griffith, all of Phoebe's hospitalists were primary care doctors. He, however, specializes in gastroenterology.

The concept of primary care hospitalists has been around for "10 or 15 years," and is growing still, Griffith said, with outpatient primary care physicians in some areas who "never come inside a hospital anymore." But he is the only gastroenterologist with the subspecialty of being a hospitalist in Albany and -- to his knowledge -- the region, he said.

"It's a team approach," Griffith said, "I'm here to complement the outpatient gastroenterologist -- to make their jobs easier."

According to Griffith, without the services of a hospitalist, outpatient physicians have to rotate "every day or two" between their office patients and those at the hospital.

"The problem is you don't get a lot of continuity of care," Griffith said, "particularly with patients who have been in the hospital for several days."

Griffith said there may be several gastroenterologists within a medical group, with hospital visits rotated among the staff. Because of that, patients may not see the same doctor twice during a hospital stay. Since Griffith is at the hospital, he said, outpatient physicians are free to concentrate on their offices, doctor-patient relationships are more easily formed at the hospital and efficiency improves overall.

"This morning, I came in and there was a man in the ER with (gastro-intestinal) bleeding. He's got black stools and he's anemic. I tell my (physician's assistant) to go see him. She goes, then calls me and tells me what's happening. In six hours, I've seen him in the ER and in the the lab. I've talked with him and scoped him.

"I can do that because I'm here. An outpatient physician may not see him till late in the day and scope him the next. This approach just compresses the event."

Griffin said he chose the hospitalist subspecialty because he "likes the sick ones."

"A lot of gastroenterology is endoscopy or 'plumbing,'" Griffith said. "It's a crucial job, but it gets boring to me. I'm a plumber. I like plumbing, but you're screening a colonoscopy and the next thing you know they're snoring. Spending a lot more time in the hospital, I get to know the people."

But Griffith says there's a downside to his subspecialty as well.

"When you do outpatient practice, the relationships tend to be longer-term," Griffin said. "When I was in Decatur, Alabama, I saw them when they were well, when they were sick and sicker, and when their (spouses) came in. I saw them when they died. Now, you really don't want to see me because that means you're really sick. Everything tends to be more intense.

"They don't know what's going to happen. (They're) at the mercy of the beast, doing all these things to you. If you can see just the one person, that helps, and I'm here all the time."