UC Davis-affiliated physicians provide hospitalist services at a Lodi medical center, helping both partners to improve triage and coordination of care.
After admission to the Adventist Health Lodi Memorial Medical Center in Lodi, eventually you’re in for something of a surprise — a personal visit from a physician with a UC Davis Health emblem on their coat or badge.
Over the past two years UC Davis has played a core role in everyday care at the 190-bed hospital in Lodi, a city of 65,000 in the northern San Joaquin Valley. The 18 hospital medicine or “hospitalist” physicians the university provides under contract there comprise the majority of Lodi’s workforce in the crucial medical specialty, which typically provides the bulk of a medical center’s oversight and coordination for inpatient cases across the spectrum.
Since the 1990s hospitalists have largely replaced primary care physicians as quarterbacks of the inpatient’s overall care, since on-site doctors are available more quickly for acute cases and their sole focus on inpatients helps to boost expertise. But because state law prevents hospitals from directly employing hospitalists, many work on a contract basis through outside physician networks or staffing corporations.
Having a downstream academic health center in the role of hospitalist provider instead is designed to offer unique advantages for both UC Davis and Lodi Memorial as they seek to fulfill the “right care, right time, right place” mantra of the current reform era.
“From a clinician’s perspective, one thing we try to bring to the table is our mission as an academic medical center to improve lives and transform care — we try to help achieve that within the Lodi community,” said Voltaire Sinigayan, M.D., a UC Davis hospitalist and the partnership’s regional medical director. “For example, in community medicine you’ll often have many doctors rotating through town. But because UC Davis is such a stalwart presence in the region, we hope to provide more stability and continuity of care.”
For one, UC Davis-affiliated hospitalists can offer greater familiarity with operations and triage practices at UC Davis Medical Center, which as the region’s tertiary and quaternary care center is the likely destination for most Lodi cases suspected to be severe enough for possible transfer.
When Lodi patients can be cared for in Lodi — closer to family and loved ones — Adventist and UC Davis now collaborate through the partnership to do so, program leaders said. When patients are transferred to UC Davis — which serves a vast 33-county region and is often highly impacted — they tend to be more specifically in need of highly advanced or specialized care than in times past. Transfers are also more likely to be smoother.
“As vice president of nursing, I think I sleep better at night knowing that the higher level of care that we sometimes require and need for our patients is a phone call or telemedicine visit away, from UC Davis,” said Debbe Moreno, R.N., Lodi Memorial’s chief nursing officer.
And when patients are discharged from either facility, the chances of a smoother transition improve again, thanks to the Lodi hospital’s existing relationships with local assisted-living facilities and other hometown care resources.
“The Lodi staff and institution have been in this community for a long time, and they really understand it, care for it and protect it,” said Leticia Sanchez Warter, M.H.A., the partnership’s administrative manager and a liaison for joint planning and operations. “At UC Davis one of our goals is to improve population health, and our partners in Lodi know what their community is all about and help us with that. With the partnership, they’ve been able to bring us in and transform the care as one.”
That local knowledge will also help to guide the partnership in its role as a potential conduit for new clinical options and best practices that emerge from the university’s academic environment, Sinigayan said.
“It’s part of that mission again to transform care — not just practicing the same things over and over, but recognizing possibilities to use innovative technologies or treatments,” he said. “My hope is to work together to feel out what the community wants and what will work best there, and then hopefully apply those (academic) insights and resources.”