THE Bermuda Hospitals Board is planning a radical shake-up of healthcare in a drive to reduce the length of time patients are hospitalised.

Officials are hoping to introduce a team of hospitalists ¿ specialists trained to take care of inpatients ¿ in order to free up general practitioners who might otherwise have to make hospital visits to check on patients.

The scheme, which is expected to be introduced in July, has been drawn up following months of consultation with the island's 30 or more GPs.

And patients will still be able to opt out of the scheme if they prefer to be treated by their family practitioner while in hospital.

Yesterday, King Edward VII Memorial Hospital's Chief of Staff, Dr. Donald Thomas III, said the new system had shown to improve healthcare and reduce hospital stays when it was introduced in other jurisdictions.

"Essentially, this programme assigns a small team of on-site specialist physicians to a patient when they are admitted into the hospital," Dr. Thomas said.

"Patients will see one of their assigned team every day to discuss their care, or more frequently if an urgent issue comes up that needs attention. Currently, GPs look after their own patients, if they are admitted to hospital.

"The benefit of the Hospitalist Programme for GPs is that they can feel assured their patients are receiving quality specialist level care at the hospital while they are extremely busy in their offices with their community patients. The benefit to patients is that they will see their care team every day and have a dedicated, on-site specialist physician while in hospital.

"Hospitalists are a relatively new kind of specialist, but are fast becoming the best practice care model in most US, Canadian and European hospitals. Benefits of Hospitalist Programmes elsewhere have shown to include reducing length of stay, and improving both patient and physician satisfaction.

"All of these are key quality-of-care indicators that are being monitored by the hospital and Board every month in order to measure improvements to the patient experience at BHB.

"Following discussions with local physicians to date, we have established that the Hospitalist Programme will be optional. If physicians prefer to care for their patients while they are in the hospital they can still elect to do so. Patients can also ask that their physician provide their care instead of the Hospitalist team.

"GPs who choose to utilise the Hospitalist Programme will be regularly communicated with about their patients to ensure continuity of care. Once hospitalised patients are discharged, they will carry on visiting their physician in the community as before. All patients cared for in the hospital will return to their primary care physician, as hospitalists do not have outpatient or community practices.

"Discussions have been taking place with community physicians over the last few months and we are developing communication materials designed to further explain the details of the Hospitalist Programme and its implementation to the community, in conjunction with our local physicians."

Commenting on the proposal, one doctor, with experience in both general practice and hospitals, pointed out that the new system will streamline care and benefit both patients and GPs.

"The care at KEMH is currently somewhat piecemeal ¿ this is a vastly better system," the physician, who asked not to be named, said.

"Up to 35 GPs will have patients in the hospital at any one time. A nurse on the ward will have to contact 35 different people to ask about patients, then 35 different doctors will come onto the ward and see one patient each.

"Communication is enormously difficult in these circumstances. The doctors do not get a nurse to 'round' with them and thus very often messages are not effectively relayed. The doctor is then busy in the office and the hospital patients may no longer be their priority.

"All this stands to change for the better with the onset of the new hospitalist system. This employs specialists in hospital internal medicine to look after the patients in hospital. These are doctors that have been trained specifically in hospital medicine.

"There will be about four teams of them ¿ not like the 35 or so independent doctors currently ¿ and they will be available for the patients 24/7. They will round every day without fail and the nurses will know exactly who to contact. They will not have offices to dash back to. Their only priority will be the hospital patients.

"The doctors looking after you in hospital will be those same ones that would be looking after you at Lahey or Johns Hopkins or all of those institutions where everyone is desperate to get their medical care. This brings us on a par with the UK and the US. In fact, in the UK it is only 'cottage' hospitals where GPs look after patients ¿ meaning that up until now KEMH has been a glorified cottage hospital. The sooner it moves out of that era the better.

"The other positive side effect is that the education of the junior doctors will be much better because there will be a senior attending leading the team. The residents will learn from watching this senior doctor at work.

"At present they are relatively unsupported within the hospital. This stands to change with this new system. It's the best thing to have happened to KEMH in a long time ¿ and if we can educate the public to believe this then the health care on the island only stands to get better."