Vicksburg internist William Wooten is in an odd position: People are hoping he’ll fail in his new venture. Well, maybe not fail, exactly, but give it up and return to his former practice.

What is a hospitalist?

• Hospitalists are physicians who devote their time solely to the care of hospitalized patients. They manage and coordinate all aspects of a patient’s stay in the hospital, from admission to discharge.

• At River Region Medical Center, the hospitalist is on duty from 7 a.m. to 7 p.m., seven days a week. He provides medical care, attends to any emergencies that arise and is available to discuss care and answer questions.

• The hospitalist makes it possible for the patient’s primary care doctor — usually an internist or family-practice physician — to remain available to his office patients.

• The hospitalist works closely with the primary care doctor and any specialists a patient requires. He gives a detailed report to the primary care doctor.

• Once a patient is discharged, medical care is transferred back to the primary care doctor.

Source: River Region Medical Center

More information can be found under the link “Hospitalist Program” at http://www.riverregion.com/Services/Pages/Services.aspx

Since Jan. 2 the longtime primary care doctor, who since 1996 had cared for patients at The Street Clinic and other Vicksburg offices, has directed River Region Medical Center’s new hospitalist program. Taking the job meant giving up his private office practice.

“I have a lot of great former patients who have really made me feel special and told me how much they miss me and wish that I had not done this,” Wooten said last week, taking a short break from his duties at River Region. “A few have actually even — nicely — wished that I would fail in this endeavor and come back into the office setting,” he said.

Giving up the close relationships he formed with patients over many years of caring for them has been the hardest part of taking on his new job, but Wooten is sold on the value of the hospitalist program.

“It’s better hands-on care for the patient throughout the day, and it’s also more efficient and more cost-effective,” he said.

Hospitalists are doctors who devote their practice solely to caring for hospitalized patients. With the new program, Vicksburg’s hospital is following a national trend started more than a decade ago, said Dr. Briggs Hopson, River Region’s vice president of medical affairs.

“The hospitalist program has really evolved, and is going to make people feel like they did years ago,” Hopson said, describing a time when doctors were able to spend time at least twice a day with their patients who’d been admitted, and even run back to the hospital from the office if it became necessary.

With busy office practices and mountains of paperwork, modern internists and family doctors don’t always have time to do that. Hospitalists, however, don’t keep office hours and thus are available all the time.

“I can give you my unqualified support that it is where this country is going, where medicine is going, and I think we’ve got some excellent physicians here,” Hopson said.

In addition to Wooten, Dr. James Hall joined the hospitalist staff in January, and River Region hopes to add another soon.

Hall is board certified in both internal medicine and nephrology — diseases of the kidney — and came to Vicksburg after seven years in practice in Brookhaven, Jackson and Memphis.

Wooten acknowledged that some patients — and some doctors — will need some time to adjust to the practice, but said it’s popular in larger cities and gradually creeping into the smaller ones.

“Like anything new or any change, there’s going to be some skepticism,” he said. “You have to wait and see what’s it’s going to be like.”

The American Medical Association likens hospitalists to designated hitters in baseball.

In a 2007 report on the trend that followed a year-long study, the AMA noted its acceptance by some of the nation’s leading hospitals, including the Cleveland Clinic; the Mayo Clinic; Brigham and Women’s and Beth Israel Deaconess hospitals in Boston; and the hospitals of the universities of Chicago, California, Michigan and Pennsylvania.

“In addition, the nation’s largest managed care programs are supportive of hospital medicine, including Humana, Kaiser, Aetna, PacificCare and CIGNA,” the report stated.

There were more than 15,000 hospitalists nationwide, the AMA study reported, and the specialty is the fastest growing profession in medicine. The Society of Hospital Medicine predicted membership in the field could double by the end of 2010.

The more serious cause for concern, the AMA found, is the high rate of burnout.

“Due to advances in outpatient care, the typical hospital patient is now sicker and may well benefit from a doctor with more experience in serious illness,” the report stated. “(But) the expectation that hospitalists can perform well while being immersed in suffering and loss day after day cannot be maintained over time.”

The report concluded by urgently recommending that hospitalists maintain a “reasonable” caseload and be assured “protected time” for teaching, research and study.

Wooten said he and Hall try to maintain a patientload that maxes out at 24. They work 7 a.m. to 7 p.m. shifts, but alternate seven-day-on, seven-day-off schedules. As the staff expands, their schedules will be adjusted, Wooten said.

Primary care physicians can opt into the program or not, based on whether they want to continue caring for their patients while they are in the hospital. At present, none of Vicksburg’s internists have chosen to do so, still preferring to see their own patients during hospital stays.

All of the local family-medicine physicians have signed on the program to some extent, Wooten said. Some give Wooten and Hall the care of all of their hospitalized patients, others just certain ones that need the benefit of a doctor right there on staff.

For all patients, the primary care physician remains just that — “Your doctor will always be your doctor,” said Diane Gawronski, River Region’s vice president of marketing and business development.

Patients have been generally positive about the change.

“They’re happy that their office doctor trusts somebody with a lot of hospital experience to take care of them for the short time that they’re here,” Wooten said.

Patients back at the office also benefit.

“One real advantage is that patients prefer not to feel rushed when they go see their physician in his office,” said Gawronski. “So the doctors have more time in the office with their office patients.”

Wooten recognizes that not having their “own” doctor while in the hospital will bother some patients.

“As long as they’re aware that if their doctor can stay in the office more frequently, they are going to be more accessible to them for most of their routine problems,” they’ll understand there’s a positive trade-off, he said.

And on the relatively rare occasion a person finds himself needing to be admitted to the hospital, it could be someone now happy to see his former internist successful in his new job.

“Dr. Wooten’s been here for such a long time, everybody within the community knows him,” Gawronski said. “When he comes to their bedside, they already feel very comfortable.”

Contact Pamela Hitchins at phitchins@vicksburgpost.com