Highland Hospital chief of hospitalists talks about career, treating patients in the evening and how he reacted to receiving the hospital’s Distinguished Physician Award
By Chris Motola
A: I see roughly eight patients a night. The patients we see are the ones who are sick enough to be in the hospital but don’t require surgery. I’m basically in charge of their care at the hospital if they are there overnight.
Q: You recently received Highland Hospital’s Distinguished Physician Award. How did you react when you heard?
A: Oh, it was the greatest honor of my career. The award is recognizing the importance of position that I fill at the hospital. I was selected by a committee made of the hospital’s leadership, all the heads of all the services, who come up with who should be recognized. I guess they felt it was my time. It’s an incredible honor.
Q: Since you’re not seeing the same patients daily, how do you bring yourself up to speed on patients who are admitted to the hospital?
A: The nuts and bolts of it is that we have access to the electronic records provided by primary care physicians. We read each other’s notes in real time and follow pretty closely. The other side of it is that, when folks are chronically ill, they do unfortunately present to the hospital more than once, so we get to know them in that aspect. Many times they’re pretty well known to us.
Q: When you’re interacting with patients in a hospital setting, how much does fear of the environment play into things? Do you have to address psychological reactions?
A: Coming from the patient’s perspective, being a new patient in the hospital can be a very frightening experience. Your health has taken a turn for the worse; you’re in a new environment. There are a lot of people in the environment that you don’t know. Our role as hospitalists is to ensure your safety and well-being, and that includes alleviating fear. We’re in charge of your care from the time you step out of the emergency department onto our floor, until the time you leave the hospital. Even afterwards, it’s our job to make sure you have the care you need when you leave. So we’re your physician, we’re your liaison, we’re your counselor. We help set your goals and expectations and we work very closely with the nursing and support staff. So we’re coordinating the care for many folks we haven’t met before.
Q: Since the job has such a large managerial aspect, to what degree does is feel like you’re on the front lines as opposed to more of a strategist?
A: We’re tasked with making the right diagnosis, giving the right treatment, and providing good communication with your primary care physician. To do that, we need to know the ins and outs of the hospital pretty well. It’s why our role was created in the first place. We’re a new position. It used to be in the hospital that you’d either see your primary care doctor or someone from a primary care physician’s group, who doesn’t necessarily know the ins and outs of the hospital. So we’re internal medicine specialists who are specialized in hospital-based medicine. We know how it’s run, know the nursing staff, know how get things done efficiently, know what tests can be done on site and know all the specialists involved in your care. We have to know the hospital very well, from top to bottom.
Q: Do the reimbursement changes to health care and the move toward outcome-based payments have an impact on your role?
A: We’re shielded from the reimbursement aspects. There is absolutely no conflict of interest. We’re not incentivized to order more, or even less, tests. We’re supposed to do the best job we can for our patients.
Q: What conditions do your patients tend to present with?
A: This flu season was interesting. We had a spike of flu A and then a spike of flu B. Along with that comes with viral illness, pneumonia, bronchitis, gastrointestinal illnesses. We dealt with a huge wave of that this winter. We also deal with a lot chronic issues that can get out of control: diabetes, high blood pressure, heart attacks, strokes, basically anything that doesn’t require the expertise of a surgeon.
Q: Was the flu shot effective this year?
A: We always recommend getting the flu shot. We see a lot of the flu because we’re one of the few hospitals in the community. So even the small outbreaks mean we’ll be seeing a lot of patients. I think the vaccine was pretty effective this year.
Q: Is there a role hospitalists can play in preventive care?
A: A lot of what we do is geared toward helping patients not have to return to the hospital. We like to make sure that people who qualify for the flu shot are getting it. If you qualify for the pneumonia shot, we’ll give you the shot. A lot of patients may be presenting with highblood pressure or diabetes for the first time, so we’ll often provide them with information about their new condition.
Q: What made Highland a good fit for you?
A: I went to the University of Rochester for medical school and they rotated us through Highland from year one. I really loved the hospital. It’s a small community that delivers big care. At Strong Memorial you have many more people you’re interacting with. Everyone knows everyone at Highland. It feels tight-knit and collegial.
Name: Youngrin Kim, M.D.
Position: Chief of hospitalists at Highland Hospital
Hometown: Flushing, N.Y.
Lives in: Henrietta
Education: Cornell University; University of Rochester School of Medicine and Dentistry
Affiliations: Highland Hospital
Organizations: American College of Physicians
Family: Married to Tien Kim, a former Highland ICU nurse. They are parents of two sons, Justin and Jason.
Hobbies: Disc, golf