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The Value of an Infectious Diseases Specialist

Posted on by CDC's Safe Healthcare Blog
Steven Schmitt, MD, FIDSA
Steven Schmitt, MD, FIDSA

Guest Author – Steven Schmitt, MD, FIDSA
Chair of the Infectious Diseases Society America’s Clinical Affairs Committee and infectious diseases physician at Cleveland Clinic

We’re all well aware that infection is a major problem among hospitalized patients, sometimes arriving with infection as a reason for admission and sometimes developing infection in the hospital.  In either case, infection is among the top causes of death in the hospital and hospital-acquired infections affect one in 20 patients. Many of these infections are resistant to antibiotics, making them extremely difficult to treat. So what is the answer?  Get patients the type of care they deserve – in this case, treatment provided by physicians who are experts in infectious diseases.  A recent study published in Clinical Infectious Diseases– based on Medicare data from nearly 130,000 hospitalized patient cases – provides strong evidence that infectious diseases expertise is invaluable. 

To quantify the value of ID physicians, we studied the records of patients who had at least one of 11 common types of infections, including Clostridium difficile, which the CDC recently named as one of the top three urgent threats in its landmark antibiotic resistance report.  Other infections included: bacteremia, central line associated bloodstream infections (CLABSI), bacterial endocarditis, HIV/opportunistic infections, meningitis, osteomyelitis, prosthetic joint infections, septic arthritis, septic shock and vascular device infections. Matching patient characteristics, we compared the outcomes of those who had seen an ID physician and those who had not. 

The results were striking. The study showed hospitalized patients who see an infectious diseases (ID) specialist are not only less likely to die in the hospital and after discharge, but stay for shorter periods and are less likely to be readmitted to the hospital. Those benefits are even more pronounced when ID specialists consult with patients within two days of admission to the hospital. Consulting early with an ID specialist saves money, too:  Medicare payments were less with early ID involvement.

All of these findings are in line with the goals of healthcare reform efforts, demonstrating that ID specialist care can improve patient outcomes while lowering costs. Healthcare-acquired infections are linked to payment penalties and bundled payments, leaving little room for error. This means the impact of ID physicians is more critical than ever to ensure high quality patient care.  We are the detectives of the medical world and have additional years of training and experience to quickly identify and treat life-threatening infections.  Let us help your patients and control healthcare costs by putting our expertise to work for you.

Posted on by CDC's Safe Healthcare Blog

5 comments on “The Value of an Infectious Diseases Specialist”

Comments listed below are posted by individuals not associated with CDC, unless otherwise stated. These comments do not represent the official views of CDC, and CDC does not guarantee that any information posted by individuals on this site is correct, and disclaims any liability for any loss or damage resulting from reliance on any such information. Read more about our comment policy ».

    I’ve been a certified Infection Proventionist for many years of my career & work at the Cleveland Clinic. Congratulations Dr. Schmitt, & to ID Teams everywhere; you are the life-savers, & now we can add ‘resource-savers’ too! This evidence further supports the importance of getting ID in sooner-rather-than-later. Cost repositioning efforts focus so much on DELETING, yet need not neglect the critical value of PARTNERING done with specialist, especially ID. Thank you.

    As much as Internal Medicine or Surgeons would like to refer their patients to an ID, it is somewhat of a dilemma. Physicians are encouraged to minimize the need for multiple consult’s. Leaving them with a choice: Do I conuslt with the neurosurgeon and endocrinologist or with the ID? Often times surgeons pick their battles and opt for the most essential hoping to be as diligent as they can when choosing the best antibiotic. Often times they rely on Pharm D’s. to adjust the antibiotics accordingly.

    Infectious diseases or for that matter, any health situation or condition is a question of culture. How do we improve the health of a society or minimize a dangerous infectious disease outbreak is simply a question of culture and individual actions on a daily, weekly, and yearly basis.

    The question that we really should ask is “Do we have a culture that really wants to be healthy?”

    Yes-You are absolutely correct-my life was spared as I had an ID doc early in my MSSA infection. He was GOD sent!
    No one new what to do and here has walked in my hospital room…handsome and assured. I though, now who the heck is this? It was an ID doctor from somewhere…ha! anyway, he guided all concerned and ran many labs…they finally found an ABX that worked and after eight months with a PICC line and the medication…I am now alive. I almost died from this infection and still wonder if it is really over? I am very careful to keep an eye on my labs, especially the CRP.

    Dr. Schmitt,

    I couldn’t agree with you more! Our oldest son had a ERCP three weeks ago and got a HAI. It was determined that his infection was caused by ESLB E Coli and the surgeon was going to discharge him on Keflex! My wife and I are pharmacists and we insisted on an ID consult. Thank GOD! The ID MD prescribed Invanz and discharged him on home IV antibiotic therapy yesterday. We found out that the lab had suggested an ID consult but it was ignored by surgery until we insisted! Not sure why ID doctors were automatically called for a consult with such a nasty bug. What happened was irresponsible and why so many patients die from HAIs. Thanks.

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