Do neurohospitalists treat only neuro problems, or do they treat every system?

[chajjohnson]

Hey everyone,

So I'm an M3 and I've done my neuro rotation, but I got zero exposure to a neurohospitalist practice. I only got outpatient and inpatient consult service. As a neurohospitalist, do you treat every system in a patient hospitalized with a primary neuro problem, or do you only treat the neuro problem and consult to someone else for any other system? For instance, if a patient is hospitalized for stroke or epilepsy, and they develop A-fib or sepsis or whatever, does the neurohospitalist treat those other problems? Or do they let another specialty deal with those problems?

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[typhoonegator]

Depends on style and culture. Everyone has their own comfort zone with handling comorbidities. Most hospitalists are not managing sepsis on the floor without any help.

 

[Thama]

Usually routine problems can be handled by a neurohospitalist but if someone is coming in septic then they probably shouldn't be on a neurology service in the first place. Many, if not most places,"neurohospitalist" is a consult service.

 

[caelum7]

It varies by hospital culture. In our academic center neurohospitalists usually manage all organ systems of a patient admitted with a primary neurological diagnosis. I manage malignant hypertension, afib, AKI, UTI, ileus routinely. If our patients develop sepsis we move them to our neuroICU where we have neurointensivists to help but we remain the primary attending. However, we feel comfortable consulting other services when things get crazy (liver failure, pancreatitis, decompensated CHF, symptomatic hyperkalemia, etc). In other hospitals, neurologists only consult and patients are cared for primarily by medicine hospitalists.

 

[NWwildcat2013]

It varies by hospital culture. In our academic center neurohospitalists usually manage all organ systems of a patient admitted with a primary neurological diagnosis. I manage malignant hypertension, afib, AKI, UTI, ileus routinely. If our patients develop sepsis we move them to our neuroICU where we have neurointensivists to help but we remain the primary attending. However, we feel comfortable consulting other services when things get crazy (liver failure, pancreatitis, decompensated CHF, symptomatic hyperkalemia, etc). In other hospitals, neurologists only consult and patients are cared for primarily by medicine hospitalists.

Sounds like a sweet gig to me. Part of me doesn't want to lose some basic medicine knowledge by becoming purely a consultant.