The cardiology wing, the emergency department, the delivery unit — there are any number of places in the hospital that health care providers consider to be their home base.
Karan Ravishankar, MD, neurohospitalist at Main Line Health, is not one of these providers. On the contrary, he has touchpoints in nearly all parts of the hospital, including the intensive care unit, emergency department and general medicine floors.
As a neurohospitalist, Dr. Ravishankar takes care of patients with neurological disorders — or conditions that impact the brain, spinal cord and nerves throughout the body. Examples include epilepsy, stroke, dementia, brain tumors and disorders related to head trauma.
"It can be a broad spectrum from emergency department consults to comanaging critically ill patients in the intensive care unit to doing routine consults for chronic to subacute neurological issues," Dr. Ravishankar explains. "I occasionally take care of patients who are recovering from neurosurgery if they have a neurological complication as a result of the surgery, including stroke or seizure."
Though the term neurohospitalist is fairly new, the medicine and care behind it are not. In their crucial roles, neurohospitalists like Dr. Ravishankar meet the needs of a wide variety of patients at Main Line Health. Here’s how.
The role of a neurohospitalist
The term hospitalist is decades old, and it refers to healthcare professionals who manage the care of hospitalized patients. Neurohospitalists are similar, with the addition of focusing on patients who have or are at risk of developing neurological disorders and diseases.
While Dr. Ravishankar cares for a range of patients, he works primarily with those who have had a stroke. Strokes — which occur when a blood vessel that carries blood to the brain is either blocked by a clot or ruptures — are common. In the US, someone has a stroke every 40 seconds.
What’s more, strokes are the primary cause of long-term disability, especially if there is any delay in treatment. If a patient walks into the emergency department with signs of a stroke, healthcare professionals like Dr. Ravishankar need to act swiftly to prevent further damage.
Because Dr. Ravishankar works a seven-day on, seven-day off schedule, he fields 100% of stroke consults for a full week. "I’m responding to stroke alerts, the majority of which are coming from the emergency room. I’m evaluating them alongside the emergency room physicians to determine if they are candidates for medication intervention or surgical evaluation," he explains.
Dr. Ravishankar also works with patients with seizures, autoimmune neurological conditions (such as multiple sclerosis) and inflammatory neurological conditions (such as transverse myelitis).
While Dr. Ravishankar spends most of his time in the hospital, he supports patients in a dedicated stroke recovery program twice a month. "The purpose of seeing patients in the clinic is to make sure everything is going to plan," he says. The clinic is also designed to help prevent future strokes, as almost one in four strokes occur in patients who have had a previous stroke.
Though he is rarely in one spot for too long, Dr. Ravishankar thrives on this schedule. "I really like the variability and the patient interaction that comes with being a neurohospitalist," he says. "You really get a chance to sit down and talk,MD to your patients. They get to know you, and you get to know them."
Neurohospitalists: An integral cog in the hospital machine
As with many roles in the hospital, neurohospitalists rarely work independently. Instead, they care for patients alongside a number of other healthcare providers.
Because neurology is a consultation-only service — meaning you can’t make an appointment directly — neurohospitalists work side-by-side with other providers on a regular basis. On any given day, Dr. Ravishankar might work with general medicine hospitalists, general medicine physicians, physician assistants, nurse practitioners, critical care providers and cardiologists.
This team approach is one of Dr. Ravishankar’s favorite parts of his role. "I like the collaborative nature of things. We get to bounce ideas off of each other, really talk through the case and work together as a team," he says. "Inevitably, we end up learning so much from our colleagues. It allows everyone to continue to grow as physicians."
Neurohospitalists and patient care at Main Line Health
If you’ve ever visited a hospital for your health or a loved one’s health, you know how many providers will make their way to your hospital room. You’ll interact with nurses, physicians, support staff and other healthcare professionals that care deeply about how your health progresses.
For patients with neurological conditions, Dr. Ravishankar and other neurohospitalists are a key piece of this care. They help limit long-term disability, improve quality of life and even save lives of those who have neurological conditions.