Veteran doctors hold key to future
If you have been admitted to the hospital recently, you may have noticed a change from tradition: Upon admission, you are suddenly placed in the care of a doctor — often a very young one — who is not your doctor, but a stranger you have never met before. This comes as a shock to those of us who remember the days when your doctor followed your care in the hospital, so long as your ailment was within his or her area of expertise.
I have learned that these doctors are a relatively new category of physician called “hospitalists,” and that their practice of medicine consists exclusively of shift work caring for hospitalized patients, and that they are increasingly displacing the physicians who practice in the traditional manner.
This issue has affected me personally. My physician, Dr. Lester Jacobson, is one of the doctors who has been displaced.
Dr. Jacobson had been on the faculty of the residency program at California Pacific Medical Center, a Sutter hospital in Pacific Heights, for nearly 40 years until he was forced out last month by hospital administrators. CPMC has decided that only hospitalists are qualified to educate residents — physicians in training — despite the fact that some hospitalists are straight out of residency programs themselves.
This is a great tragedy. I know from firsthand experience that Dr. Jacobson is an extraordinary physician and still cares for his patients traditionally, both inside and outside the hospital, because he takes pride in doing everything possible for his patients himself. In examining you in the hospital, he will bring to bear all of the knowledge that he has gained from your visits to his office over the years.
The relationship between veteran doctors and residents has always been symbiotic: The doctors provide supervision and education for no cost, and in return the residents aid in caring for their patients. Without the assistance of the residents, it is now impossible for a doctor to care for his or her hospitalized patients, who are being denied access to care and support at the time they need it most.
Tradition is more important than ever in times of change, particularly when it comes to educating a generation that has no experience with the previous era. In my own field, the transition from celluloid to digital film means movies today are made in a totally different manner than before. Yet when new or aspiring filmmakers come to me for advice, I direct them back to books on how to make films in the old way, as understanding the tradition is the only way to truly learn the art. Learning from doctors like Dr. Jacobson is like learning from one of the old masters of filmmaking, and physicians-in-training should not be denied such an extraordinary opportunity.