FirstHealth Moore Regional Hospital and Pinehurst Medical Clinic (PMC) have agreed to combine their hospitalist programs, a move that will provide expanded coverage for hospitalized patients.

The merger of the two services will take place in phases over the summer, with implementation to be completed by Sept. 1. The PMC hospitalists will become members of Moore Regional's Hospitalist Service.

Hospitalists are internal medicine physicians whose only responsibility is caring for patients who are in the hospital. They provide around-the-clock care, seeing each patient as often as needed and ensuring timely follow-up on tests and treatments.

They do not have outside medical practices.

"The PMC hospitalists are excellent physicians and will be great additions to our hospitalist team," says Dr. George Bussey, chief medical officer for FirstHealth of the Carolinas. "They will help improve the efficiency and quality of the care that our patients receive."

Moore Regional has had a hospitalist program for several years, but many of the internal medical physicians at PMC continued to take care of their own hospitalized patients.

Eighteen months ago, PMC hired three hospitalist physicians to care for PMC patients in the hospital.

"Earlier this year, we were thinking about expanding our hospitalist program, but after considering a range of options, we decided to approach the hospital about combining our resources," says Dr. Walter Morris, of PMC. "We felt that was the best thing to do, because of the benefits it would provide to our patients."

Many hospitals have added hospitalist physicians to their staff simply because primary care physicians can't be in two places at the same time -- in the hospital and in their offices seeing patients.

"Our internal medicine physicians have been finding it increasingly difficult to spend the time required to look after their patients in the hospital, and this can affect the quality of outpatient care we want to provide for our patients," Morris says.

Dr. Daniel Barnes, medical director of the Hospitalist Service at Moore Regional, says it is good for hospital inpatients to be cared for by doctors who spend all of their time in the hospital.

"In addition to making rounds in the morning, we can come back and re-visit patients later in the day," he says. "And if test results come in that indicate we could let them go home, they might not have to wait until the next day."

According to Barnes, hospitalists are also more accessible both to patients and their families.

"If the family can only come to the hospital at a certain time of day, we can arrange to meet with them at their convenience," he says.

Primary care physicians are also better able to take care of their office patients if they don't have to come to the hospital in the middle of the night to deal with emergencies, Barnes says.

"It's going to free up primary care doctors for more outpatient appointments and should make it easier for patients to get in to see their regular doctor," he says. "That will improve health care delivery, so I think it's a win for everybody."

While a person's regular primary care physician may be able to add a slightly more personal touch to hospital care, that care is often less efficient and patient-physician contact is less frequent, Morris says.

"Inefficiencies can lead to problems in the quality of care," he says. "If you are seeing patients in your office and an emergency comes up with one of your patients in the hospital, then something has to give. It's more and more difficult for primary care physicians to be in two places, whereas hospitalists are always right there on the spot to provide good, efficient care."

As part of the agreement between Moore Regional and PMC, if a PMC patient needs to be examined or treated by a medical specialist (such as a cardiologist) while in the hospital, that patient will be seen by a PMC specialist.

"If Pinehurst Medical Clinic patients have already been seeing a PMC specialist, they will continue to see that same specialist while they are in the hospital," Bussey says.

When hospitalist patients are discharged from the hospital, the hospitalist who admitted them sends detailed records to their primary care provider and arranges for any needed follow-up treatment or appointments with the primary care provider.

"This is a good example of leaders at the hospital and our clinic getting together to come up with a solution that will ultimately help all of the patients in our area," says Dr. Morris. "I have been very pleased with the process and the outcome."

"The PMC primary care providers can spend more time with patients in the office setting knowing that their hospitalized patients will continue to receive the best care possible from specialists trained in hospital medicine," Bussey says. "The combined program gives our hospitalized patients the comfort of knowing that doctors are always 'in the house' to manage their care."