The name at the head of the bed

To the Editor: Our hospitals and hospital-based colleagues provide wonderful care and, unfortunately, most of us will require inpatient care at some stage in our lives: we are all aware of increasingly complex comorbidity and polypharmacy problems as we age.

An apparent impasse between community care and hospital discharges and admissions remains, even though information technology in the 21st century should make life easier. This has fiscal, medical and social sequelae.

Finding a solution to this requires a complex debate, which should remain focused on the best outcomes for our patients.

Who looks after the patient in hospital? There is naturally a team of doctors and allied health personnel. The team leader is usually a consultant whose name is listed at the head of the patient's bed.

The Academy of Medical Royal Colleges in the United Kingdom recently endorsed this concept, ensuring that patients, their relatives and carers will know “which doctor is ultimately responsible for all aspects of their care”.1

So where do community physicians fit into all of this? Because real life does happen outside hospitals, and patients actually return to their communities!

My patients, especially those with complex problems, complain recurrently about a loss of continuity between their hospital and their general practitioner.

A critical innovation could be that the patient's GP is listed alongside the name of the relevant specialist colleague at the head of the bed.

The patient would then be reassured that their prime medical carer has close alignment with the hospital staff, and junior hospital staff would know who to contact on admission and discharge, ensuring a smoother transition and reducing fragmentation.

This would be a win-win situation for all concerned!