Hospitalists seen as advantageDoctor says working together helps patients and staff

Dr. Johany Herrera is one of 14 hospitalists who help speed up care at Medical Center Hospital.
Hospitalists are hospital-based family physicians or internists who can take care of patients, communicate with their primary care doctors and discharge the patients cutting down on the time they spend in the hospital by half.
Herrera, who is director of the MCHS ProCare Hospitalist Group, said the average number of days patients used to stay in the hospital was 10. Now it’s five. At the hospital 24-7, hospitalists usually see 15 to 20 patients a day and work seven days on and seven days off.
MCHS stands for Medical Center Health System.
MCH’s hospitalist program began in May 2007. For years, Herrera said, primary care doctors would work in their offices until 5 p.m. or 6 p.m. and come to the hospital from 6 p.m. to 10 a.m., which kept them away from their families and children. The primary care physicians have a contract with the hospitalists, he said.
At first, Herrera said, there was a lot of resistance to the hospitalist idea because the primary care doctors thought the hospitalists would take their patients, but as “soon as they saw the great results, almost every physician in the community uses them.”
Herrera added that doctors also are able to see more patients in their clinics and the nursing staff is happy, too, because they are able to reach a doctor more quickly.
“For us, we’re right here,” he said.
Cardiologist Dr. Fernando Boccalandro said hospitalists are a big advantage for specialists because they can tackle the main issues a patient has when they arrive at the hospital late at night or early in the morning. Previously, he would have to go into the hospital to take care of his patient.
“They have a tremendous help because we don’t have run from Fort Stockton to write the order because we know someone has already evaluated the patient and can take care of them right away,” Boccalandro said. “It alleviates a lot of pressure we used to have before.”
He added that it’s good to have a physician on hand 24-7 that he and other primary care doctors can communicate with and present information on patient conditions. Boccalandro said primary care doctors also can give the hospitalists information about how to take care of the patient.
Boccalandro said a lot of the processes at the hospital function much better if there is a physician there all the time if there are fires to put out.
He added that it’s also beneficial for patients because the hospitalists focus on people in the hospital. “The yang of the problem is that, of course, it’s so much easier for your physician who knows your problems and preferences to see you in the hospital world because they know you. That’s the big vexing question about hospital medicine,” Boccalandro said. “You get a gain, but you get a loss too. …”
Herrera said he finds being a hospitalist rewarding because patients come in really sick and you can see them recover.
A native of Manizales, Colombia, Herrera said he did his last year of medical school in Monterrey, Mexico. He met his wife there and they journeyed to the United States. Herrera said he did his residency at Bronx-Lebanon Hospital in New York City.
As a child, Herrera grew up in an “extremely poor family” in a “tough neighborhood.” He got interested in medicine through an aunt who was a licensed vocational nurse.
“She worked in a hospital there. Every time she came home, she used to just take me to give free shots to people, to do wound care, to do everything. So from the beginning, I loved that. I loved the blood and wounds. It was just exciting to me,” Herrera recalled.
“Since I was extremely poor, she always used to ask me, ‘What do you want to do when you grow up?’ I said, ‘You know I like to help. I like to do what you do, but I don’t want to be poor all my life.’ So she said, ‘Well, you could be a doctor and doctors make good money and they help people,’” Herrera said.
“This sounds perfect to me and here I am,” he added.
By the time he had gotten to the last year of his medical education, Herrera said he had delivered more than 200 babies and performed appendectomies and other procedures.
In his job at Medical Center, where he’s been since 2010, Herrera said he encounters a lot of variety because there are so many small towns around the region that send their patients to the hospital. When some patients get to MCH, they have waited so long to see a doctor that they are “really, extremely sick.”
“We see everything and we have a lot of immigration population, as well,” Herrera said.
The most common illnesses he sees this time of year are pneumonia and flu. Heart attacks, stroke and all types of cancer also are prevalent, Herrera said. Psych patients also come through with medical problems, he said.
Herrera said he loves working at MCH, partly because it is well-run and organized and the nurses and doctors are “very engaged.”
“That way we are focused on what’s better for the patient,” he said.
Before he started heading the hospitalist program at MCH, Herrera said he used his time off to work a few days at Midland Memorial Hospital and a private prison in Big Spring. Herrera and his wife, Shiram, have three children. Shiram is a nurse practitioner who works part time for a private physician.
“She likes the outpatient part; I love the inpatient part,” Herrera said.