Dr. David Walsh, an internist who specializes in inpatient care, has been named chief of the new Division of Hospital Medicine in the Department of Medicine at the Medical College of Georgia at Augusta University.
Walsh, who came to MCG from Vanderbilt University School of Medicine, where he was associate program director of the Department of Internal Medicine Residency Program, started his new job Sept. 1. Hospital medicine at MCG was part of the Department of Emergency Medicine prior to Walsh’s arrival.
Hospitalists are generally internal medicine-trained physicians, as well as some family medicine physicians and pediatricians, who only practice in a hospital. The discipline grew, mostly over the last 20 years, out of the increasingly complex medical problems of patients who needed hospitalization and the need for dedicated clinicians to oversee their care management, according to the American College of Physicians.
The care of hospitalized patients has traditionally been handled by clinicians who often also carry a full panel of outpatients.
“I consider hospitalists an inpatient mirror to outpatient primary care providers,” Walsh says. “Because we practice exclusively in the hospital, we know the hospital better from a technical and operational standpoint. We are kind of in the background making sure everything runs smoothly.”
For instance, he explains, when a patient with HIV and pneumonia needs to be admitted, he would be admitted by the hospitalist team, but his infectious disease physician would remain an integral part of the care team — still handling his HIV-related treatments and following up on a daily basis. “We would be there to make sure admission and discharge run smoothly and that any non-infectious disease related issues were taken care of,” Walsh explains. “It’s a collaborative effort.”
At Augusta University Health, the teaching hospital for MCG, and at many other academic health centers, primary care resident physicians like those in the Department of Family Medicine also care for inpatients as part of their training. That will continue, Walsh says. Faculty in the new division, some with appointments in family medicine, treat only inpatients.
“We want to ensure the continuity of care,” he says. “How best to do that is an area of growing research because we know that the more times patients are handed off, the higher the risk for errors.”
There are a lot of initiatives out there to try and reduce those errors. In fact, according to the Society of Hospital Medicine, many hospitalists are an integral part of hospitals’ quality improvement teams, simply because they know the ins and outs of hospitals and can often identify ways to quickly improve and standardize patient care practices. As an example, Walsh says he’d like to work to standardize regular training at MCG and AU Health for routine procedures like lumbar punctures and thoracentesis — the use of a needle to remove fluid between the lungs and chest wall — both procedures hospitalists perform regularly.
He’d also like to eventually grow the division, which includes 18 faculty, some with primary appointments in the Department of Family Medicine. The division also currently includes an associate program director for the internal medicine residency program and a faculty member dedicated to running the internal medicine/hospitalist undergraduate medical education curriculum.
“We’ve already got a great footprint in medical education,” he says. “I’m excited to grow quality improvement, research and the clinical practice. There’s great opportunity here.”
Walsh earned his medical degree from the University of Louisville School of Medicine in Louisville, Kentucky, and completed internal medicine training at the Medical University of South Carolina in Charleston, including a year as chief resident.