Hospitalist Barriers to Using a Personal Business Card

Hospitalist Barriers to Using a Personal Business Card | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Short Report Hospitalist Barriers to Using a Personal Business Card Stephen Biederman, Ajin John, Marie Kreck, Atinuke Komolafe, Gonzalo Bearman, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6428714/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 11 You are reading this latest preprint version Abstract Business cards show promise as an intervention to improve rapport between clinicians and patients but have not been well-studied in clinical practice. We trialed business cards with a group of hospital medicine clinicians on one inpatient medical unit and measured the impact to clinicians and patients. Overall, hospitalists supported the intervention, though they raised concerns about the more personal elements on the cards. Female physicians had greater concerns than male physicians. Patients found the cards useful, and there was in increase in the percentage who could identify their own physician, though improvements in their knowledge of hospital medicine was not noted. Patient satisfaction with ‘Communication with Doctors’ improved during the time of the intervention. Business cards appear to be an acceptable and feasible intervention for improving rapport between patients and healthcare clinicians. More study is needed to identify how to structure business cards to meet patient and hospitalist needs. Patients responded well to a personalized business card (BC) from their hospitalists finding it helpful in their care experience. While hospitalists supported this initiative they raised concerns about privacy and safety. Future efforts will focus on understanding how BCs impact workplace safety and patient satisfaction as well as identifying the most valuable aspects for patients while balancing the needs of hospitalists Figures Figure 1 Figure 2 Introduction Because hospitalization is often stressful and confusing for patients and families, hospitalists play a pivotal role in helping patients and families by navigating complex treatment plans, integrating multiple consultant and ancillary service recommendations, and providing guidance and reassurance. To achieve this, hospitalists need to quickly establish rapport and foster trust with patients and families. One strategy to enhance the patient-clinician relationship is increasing the patient’s familiarity with their clinician (physician or advanced practice provider [APP]). However, most hospital medicine patients are unable to identify their hospitalist [ 1 ] and have little understanding of the role of a hospitalist [ 2 ]. Business cards (BC) for hospitalists may be one approach to build rapport, help patients identify their hospitalist clinicians, and understand the role of their clinician [ 3 – 6 ], but little is known about hospitalist perspectives on the use of BC. The objective of this study was to investigate the perspective of hospitalists regarding using BC in a tertiary care academic hospital. Methods Over the months of August and September 2024, hospitalists carried oversized, personalized BCs containing elements reviewed and recommended by the hospital’s ‘Patient Family Advisory Council’ (PFAC) to help patients build trust and rapport with their hospitalist. The PFAC consists of patients who volunteer to advise the hospital on opportunities to improve the delivery of care and experience of future patients. The elements included on the BC were the clinician’s name, academic title, photo, education, and one sentence about the individual. The one-sentence “Getting to know me” statement was intended to communicate the clinician’s humanity but not convey meaningful personal information. The hospitalists wrote these statements themselves, writing what they wished or working from a generic prompt, such as, “My favorite part of working here is …” The back of the card contained general education about hospitalists and hospital medicine and a QR-code linking to additional information online. We distributed the cards to hospitalists at the start of a 7-day rounding stretch and left it to their discretion if and when they would give the card to patients. Following the two-month pilot, all hospitalists were asked to complete a questionnaire about their perspectives on the use of the cards. The questionnaire asked about demographics and barriers to card use and also included a 5-point Likert scale on comfort with specific elements on the card. Each Likert response was given a point value from 1 (strongly disagree) to 5 (strongly agree). Additionally, we conducted surveys with patients on the unit on random days for the month prior to interventions and during the intervention period to assess patients’ perspective on receiving a BC and their understanding of their inpatient care team. Another secondary outcome was Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores in the dimension of physician communication during the intervention. This project was reviewed by the institution’s Protocol Review Oversight Committee and deemed IRB-exempt as a quality improvement project not collecting any personal health information. This article is reported according to the Standards for Quality Improvement Reporting Excellence 2.0 (Squire 2.0) guidelines [ 7 ]. Results We distributed the questionnaire among an academic hospitalist group consisting of 41 APPs and 74 physicians. 30.4% (35/115) of all clinicians completed it. Most respondents were physicians at 82.9% (29/35). 60% (21/35) of respondents were women, 22.9% (8/35) were men, and 17.1% (5/35) preferred not to say. 68.6% (24/35) had been practicing independently for > 5 years. Hospitalists generally agreed that they felt comfortable with inclusion of their first name (mean score 3.6), last name (mean score 3.74) and photo (mean score 3.43). Results were more mixed for comfort about including education (mean score 3.26) and academic rank (mean score 3.26), and a majority felt uncomfortable with a personal sentence on a BC (mean score 2.49) (Fig. 1 ). The biggest barriers to using a BC were too much personal information, fear of harassment, and the physical size of the cards (Fig. 2 ). These concerns were more prevalent among women compared to men, with 50% (4/8) of men identifying no barriers to BC use and only 5% (1/21) of women identifying no barriers. Overall, hospitalists were in favor of continuing to use BC with select patients (mean score 3.60) but were opposed to allowing other individuals to hand out a BC on their behalf (mean score 2.34). During patient surveys in the pre-intervention phase, 5.9% (2/34) of patients indicated that they received a BC. This percentage increased to 46.7% (7/15) during the intervention. Patient knowledge of the name of their physician in charge of their care increased from 32.3% (11/34) to 53.3% (8/15). 54.6% of patients had heard of the title of a ‘hospitalist’ pre-intervention, and 46.7% had heard of hospitalists post-pilot. Understanding of what a hospitalist was low in both groups at 29.4% and 33.4%. For the 10-months prior to the intervention, 74.1% of patients ranked the hospital highly in the dimension of Communication with Doctors on HCAHPS. This increased to 93% of patients ranking the hospital highly for communication with doctors during the pilot period of July – August 2024. Discussion In this QI project, creation and distribution of a personalized BC among a hospitalist group was correlated with a positive reception from patients and increased HCAHPS scores for physician communication. These impacts may reflect a sense of increased transparency, connection and collaboration between clinician and patient. The positive reception aligns with previous research that demonstrates that clinicians that use BC are perceived to be more proficient communicators with better medical knowledge and provide better medical care [ 6 ]. Perspectives from hospitalists themselves were more mixed. Hospitalists generally felt comfortable with a BC that they could distribute to patients, but some, especially women, identified privacy and harassment concerns as barriers. This identifies a need to implement strategies to increase female clinician BC utilization while respecting the balance between professional visibility and personal boundaries, especially given higher rates of harassment and mistreatment experienced by female physicians [ 8 ]. Some strategies may include using more standardized cards that clinicians feel more comfortable distributing or systemic policy changes addressing and increasing safety for clinicians who feel more vulnerable. In this study we found that patients had significant confusion surrounding hospitalist medicine and the role of hospitalists. These findings are similar to a cross-sectional study examining inpatients’ understanding of hospitalist and other medical terminology where many patients were unfamiliar with the role of a hospitalist as well as other common medical terms [ 2 ]. Previous studies have shown that hospitalized patients have difficulty identifying their in-hospital physicians [ 1 ] and their plan of care [ 9 ]. More work is needed to support patients in navigating complex medical terms and understanding the roles of the many healthcare staff they encounter while hospitalized. BCs may be an element of overcoming these challenges. Few studies have investigated use of BC; however, one study created standardized hospitalist information cards and found that use of cards improved the odds of high scores on HCAHPS [ 6 ]. Notably, that study excluded patients who did not receive a BC. Our QI project did not differentiate whether patient received a card or not in terms of patient experience outcomes, and we found that more than 50% of patients expressed that they were not given a BC. Of critical importance was preservation of clinician autonomy so we chose to study broadly how the creation and distribution of cards would impact clinician practice, their perspectives, and, secondarily, patient experience outcomes. This study suggests more rigorous evaluation of the impact of BC to include patient outcomes would be worthwhile. Limitations This QI project has several limitations. The pilot period was brief and conducted on one medical unit. As the use of a BC was left completely to the discretion of the hospitalists, many patients may not have received the intervention. It was also only conducted among one hospitalist group, so generalizability to other specialties may be limited. However, as a natural experiment of the BC intervention this study shows that it is feasible and may be beneficial in real-world practice. Conclusion Patients responded positively to a personalized BC. Hospitalists supported implementation of personalized BC but expressed concerns surrounding privacy and safety. Further exploration into the impact of BC on workplace safety and patient satisfaction is needed, and in future exploration, it will be useful to identify which aspects of the business card are most helpful to the patients and use that information to balance the needs of patients and hospitalists. Future iterations of this QI project will explore balancing the needs expressed by patients—such as having a physical card given to them by their clinician and connecting to their clinician as a human—and the needs of hospitalists, such as maintaining professional boundaries and ensuring clinician safety from harassment. Declarations Ethics approval and consent to participate: This project was reviewed by the institution’s Protocol Review Oversight Committee and deemed IRB-exempt as a quality improvement project not collecting any personal health information. This article is reported according to the Standards for Quality Improvement Reporting Excellence 2.0 (Squire 2.0) guidelines [7]. Both the patients who were interviewed and the hospitalists who completed surveys gave their consent to participate in the quality improvement project and surveys. All information was anonymous, and no patient or hospitalist identifiers were collected. Data Availability Statement: The data that support the findings of this study are not openly available but are available from the corresponding author upon reasonable request. Data are located in controlled access storage at VCU Health System. Funding: No funding for this project. Clinical trial number: not applicable Human ethics and consent to participate declarations : not applicable. References Arora V, Gangireddy S, Mehrotra A, Ginde R, Tormey M, Meltzer D. Ability of hospitalized patients to identify their in-hospital physicians. Arch Intern Med. 2009;169(2):199–201. doi: 10.1001/archinternmed.2008.565 Curatola N, Juergens N, Atkinson MK, et al. Inpatients’ understanding of the hospitalist role and common medical terminology. J Hosp Med. Published online August 28, 2024. doi: 10.1002/jhm.13492 Zucco L, Desmond G, Carpenter B. Identity cards help patients identify their doctors. BMJ Qual Improv Rep. 2014;2(2):u539.w574. doi: 10.1136/bmjquality.u539.w574 Wahlberg K, Lambirth S, Gardner Z. Improving patients’ ability to identify their physicians through the use of physician facecards and whiteboards. BMJ Open Qual. 2019;8(2):e000606. doi: 10.1136/bmjoq-2018-000606 Suparna Dutta, MD, MPH, Francis Fullam, MA, Jay M. Behel, PhD. How We Improved Hospitalist-Patient Communication. Catalyst Carryover. 2017;3(1). doi: 10.1056/CAT.17.0531 Abid MH, Lucier DJ, Hidrue MK, Geisler BP. The Effect of Standardized Hospitalist Information Cards on the Patient Experience: a Quasi-Experimental Prospective Cohort Study. J Gen Intern Med. 2022;37(15):3931–3936. doi: 10.1007/s11606-022-07674-3 Ogrinc G, Davies L, Goodman D, Batalden P, Davidoff F, Stevens D. SQUIRE 2.0 ( Standards for QUality Improvement Reporting Excellence) : revised publication guidelines from a detailed consensus process: Table 1. BMJ Qual Saf. 2016;25(12):986–992. doi: 10.1136/bmjqs-2015-004411 Dyrbye LN, West CP, Sinsky CA, et al. Physicians’ Experiences With Mistreatment and Discrimination by Patients, Families, and Visitors and Association With Burnout. JAMA Network Open. 2022;5(5):e2213080. doi: 10.1001/jamanetworkopen.2022.13080 O’Leary KJ, Kulkarni N, Landler MP, et al. Hospitalized patients’ understanding of their plan of care. Mayo Clin Proc . 2010;85(1):47–52. doi: 10.4065/mcp.2009.0232 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 24 May, 2025 Reviews received at journal 24 May, 2025 Reviews received at journal 21 May, 2025 Reviewers agreed at journal 20 May, 2025 Reviews received at journal 15 May, 2025 Reviewers agreed at journal 15 May, 2025 Reviewers invited by journal 07 May, 2025 Editor assigned by journal 07 May, 2025 Editor invited by journal 05 May, 2025 Submission checks completed at journal 02 May, 2025 First submitted to journal 02 May, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6428714","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Short Report","associatedPublications":[],"authors":[{"id":455438983,"identity":"dabea1df-26ee-4272-afdd-2959628452dd","order_by":0,"name":"Stephen Biederman","email":"data:image/png;base64,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","orcid":"","institution":"Virginia Commonwealth University","correspondingAuthor":true,"prefix":"","firstName":"Stephen","middleName":"","lastName":"Biederman","suffix":""},{"id":455438984,"identity":"f80b8cc0-0b6d-4fd6-9a20-d9fb1925a484","order_by":1,"name":"Ajin John","email":"","orcid":"","institution":"Virginia Commonwealth University","correspondingAuthor":false,"prefix":"","firstName":"Ajin","middleName":"","lastName":"John","suffix":""},{"id":455438985,"identity":"5757a6e2-6f24-4525-a094-809325928f66","order_by":2,"name":"Marie Kreck","email":"","orcid":"","institution":"Virginia Commonwealth University","correspondingAuthor":false,"prefix":"","firstName":"Marie","middleName":"","lastName":"Kreck","suffix":""},{"id":455438986,"identity":"43bfce8f-990b-486d-958f-83e90347f109","order_by":3,"name":"Atinuke Komolafe","email":"","orcid":"","institution":"Virginia Commonwealth University","correspondingAuthor":false,"prefix":"","firstName":"Atinuke","middleName":"","lastName":"Komolafe","suffix":""},{"id":455438987,"identity":"bc91b069-1239-451d-b47b-fb3749490024","order_by":4,"name":"Gonzalo Bearman","email":"","orcid":"","institution":"Virginia Commonwealth University","correspondingAuthor":false,"prefix":"","firstName":"Gonzalo","middleName":"","lastName":"Bearman","suffix":""},{"id":455438989,"identity":"523e095d-34d7-4eeb-bb04-6a8e401651b6","order_by":5,"name":"Alan Dow","email":"","orcid":"","institution":"Virginia Commonwealth University","correspondingAuthor":false,"prefix":"","firstName":"Alan","middleName":"","lastName":"Dow","suffix":""}],"badges":[],"createdAt":"2025-04-11 13:23:12","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6428714/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6428714/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":82711419,"identity":"2a99b9ec-c167-4637-a450-8231028e35ff","added_by":"auto","created_at":"2025-05-14 11:33:10","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":258667,"visible":true,"origin":"","legend":"\u003cp\u003eHospitalist Agreement and Disagreement with Inclusion of Each Item\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-6428714/v1/de7dd76b96ddfa29d8c05e8d.jpeg"},{"id":82713022,"identity":"7bdf3b95-5b47-41e6-98c0-067c679e0f66","added_by":"auto","created_at":"2025-05-14 11:49:10","extension":"jpeg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":290489,"visible":true,"origin":"","legend":"\u003cp\u003eHospitalists’ Barriers to Using a Personalized Business Card by Gender\u003c/p\u003e","description":"","filename":"floatimage3.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-6428714/v1/b9d461de3f79074428aec42d.jpeg"},{"id":82713023,"identity":"080403b0-689d-4e13-a2c0-962c518d757f","added_by":"auto","created_at":"2025-05-14 11:49:15","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":857104,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6428714/v1/7a459493-4648-4c3c-aa61-9f33a977c60c.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Hospitalist Barriers to Using a Personal Business Card","fulltext":[{"header":"Introduction","content":"\u003cp\u003eBecause hospitalization is often stressful and confusing for patients and families, hospitalists play a pivotal role in helping patients and families by navigating complex treatment plans, integrating multiple consultant and ancillary service recommendations, and providing guidance and reassurance. To achieve this, hospitalists need to quickly establish rapport and foster trust with patients and families. One strategy to enhance the patient-clinician relationship is increasing the patient\u0026rsquo;s familiarity with their clinician (physician or advanced practice provider [APP]). However, most hospital medicine patients are unable to identify their hospitalist [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e] and have little understanding of the role of a hospitalist [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Business cards (BC) for hospitalists may be one approach to build rapport, help patients identify their hospitalist clinicians, and understand the role of their clinician [\u003cspan additionalcitationids=\"CR4 CR5\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e], but little is known about hospitalist perspectives on the use of BC. The objective of this study was to investigate the perspective of hospitalists regarding using BC in a tertiary care academic hospital.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eOver the months of August and September 2024, hospitalists carried oversized, personalized BCs containing elements reviewed and recommended by the hospital\u0026rsquo;s \u0026lsquo;Patient Family Advisory Council\u0026rsquo; (PFAC) to help patients build trust and rapport with their hospitalist. The PFAC consists of patients who volunteer to advise the hospital on opportunities to improve the delivery of care and experience of future patients. The elements included on the BC were the clinician\u0026rsquo;s name, academic title, photo, education, and one sentence about the individual. The one-sentence \u0026ldquo;Getting to know me\u0026rdquo; statement was intended to communicate the clinician\u0026rsquo;s humanity but not convey meaningful personal information. The hospitalists wrote these statements themselves, writing what they wished or working from a generic prompt, such as, \u0026ldquo;My favorite part of working here is \u0026hellip;\u0026rdquo; The back of the card contained general education about hospitalists and hospital medicine and a QR-code linking to additional information online.\u003c/p\u003e \u003cp\u003eWe distributed the cards to hospitalists at the start of a 7-day rounding stretch and left it to their discretion if and when they would give the card to patients. Following the two-month pilot, all hospitalists were asked to complete a questionnaire about their perspectives on the use of the cards. The questionnaire asked about demographics and barriers to card use and also included a 5-point Likert scale on comfort with specific elements on the card. Each Likert response was given a point value from 1 (strongly disagree) to 5 (strongly agree).\u003c/p\u003e \u003cp\u003eAdditionally, we conducted surveys with patients on the unit on random days for the month prior to interventions and during the intervention period to assess patients\u0026rsquo; perspective on receiving a BC and their understanding of their inpatient care team. Another secondary outcome was Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores in the dimension of physician communication during the intervention.\u003c/p\u003e \u003cp\u003eThis project was reviewed by the institution\u0026rsquo;s Protocol Review Oversight Committee and deemed IRB-exempt as a quality improvement project not collecting any personal health information. This article is reported according to the Standards for Quality Improvement Reporting Excellence 2.0 (Squire 2.0) guidelines [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eWe distributed the questionnaire among an academic hospitalist group consisting of 41 APPs and 74 physicians. 30.4% (35/115) of all clinicians completed it. Most respondents were physicians at 82.9% (29/35). 60% (21/35) of respondents were women, 22.9% (8/35) were men, and 17.1% (5/35) preferred not to say. 68.6% (24/35) had been practicing independently for \u0026gt;\u0026thinsp;5 years. Hospitalists generally agreed that they felt comfortable with inclusion of their first name (mean score 3.6), last name (mean score 3.74) and photo (mean score 3.43). Results were more mixed for comfort about including education (mean score 3.26) and academic rank (mean score 3.26), and a majority felt uncomfortable with a personal sentence on a BC (mean score 2.49) (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The biggest barriers to using a BC were too much personal information, fear of harassment, and the physical size of the cards (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). These concerns were more prevalent among women compared to men, with 50% (4/8) of men identifying no barriers to BC use and only 5% (1/21) of women identifying no barriers. Overall, hospitalists were in favor of continuing to use BC with select patients (mean score 3.60) but were opposed to allowing other individuals to hand out a BC on their behalf (mean score 2.34).\u003c/p\u003e \u003cp\u003eDuring patient surveys in the pre-intervention phase, 5.9% (2/34) of patients indicated that they received a BC. This percentage increased to 46.7% (7/15) during the intervention. Patient knowledge of the name of their physician in charge of their care increased from 32.3% (11/34) to 53.3% (8/15). 54.6% of patients had heard of the title of a \u0026lsquo;hospitalist\u0026rsquo; pre-intervention, and 46.7% had heard of hospitalists post-pilot. Understanding of what a hospitalist was low in both groups at 29.4% and 33.4%. For the 10-months prior to the intervention, 74.1% of patients ranked the hospital highly in the dimension of Communication with Doctors on HCAHPS. This increased to 93% of patients ranking the hospital highly for communication with doctors during the pilot period of July \u0026ndash; August 2024.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this QI project, creation and distribution of a personalized BC among a hospitalist group was correlated with a positive reception from patients and increased HCAHPS scores for physician communication. These impacts may reflect a sense of increased transparency, connection and collaboration between clinician and patient. The positive reception aligns with previous research that demonstrates that clinicians that use BC are perceived to be more proficient communicators with better medical knowledge and provide better medical care [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003ePerspectives from hospitalists themselves were more mixed. Hospitalists generally felt comfortable with a BC that they could distribute to patients, but some, especially women, identified privacy and harassment concerns as barriers. This identifies a need to implement strategies to increase female clinician BC utilization while respecting the balance between professional visibility and personal boundaries, especially given higher rates of harassment and mistreatment experienced by female physicians [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Some strategies may include using more standardized cards that clinicians feel more comfortable distributing or systemic policy changes addressing and increasing safety for clinicians who feel more vulnerable.\u003c/p\u003e \u003cp\u003eIn this study we found that patients had significant confusion surrounding hospitalist medicine and the role of hospitalists. These findings are similar to a cross-sectional study examining inpatients\u0026rsquo; understanding of hospitalist and other medical terminology where many patients were unfamiliar with the role of a hospitalist as well as other common medical terms [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Previous studies have shown that hospitalized patients have difficulty identifying their in-hospital physicians [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e] and their plan of care [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. More work is needed to support patients in navigating complex medical terms and understanding the roles of the many healthcare staff they encounter while hospitalized. BCs may be an element of overcoming these challenges.\u003c/p\u003e \u003cp\u003eFew studies have investigated use of BC; however, one study created standardized hospitalist information cards and found that use of cards improved the odds of high scores on HCAHPS [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Notably, that study excluded patients who did not receive a BC. Our QI project did not differentiate whether patient received a card or not in terms of patient experience outcomes, and we found that more than 50% of patients expressed that they were not given a BC. Of critical importance was preservation of clinician autonomy so we chose to study broadly how the creation and distribution of cards would impact clinician practice, their perspectives, and, secondarily, patient experience outcomes. This study suggests more rigorous evaluation of the impact of BC to include patient outcomes would be worthwhile.\u003c/p\u003e"},{"header":"Limitations","content":"\u003cp\u003eThis QI project has several limitations. The pilot period was brief and conducted on one medical unit. As the use of a BC was left completely to the discretion of the hospitalists, many patients may not have received the intervention. It was also only conducted among one hospitalist group, so generalizability to other specialties may be limited. However, as a natural experiment of the BC intervention this study shows that it is feasible and may be beneficial in real-world practice.\u003c/p\u003e"},{"header":"Conclusion","content":" \u003cp\u003ePatients responded positively to a personalized BC. Hospitalists supported implementation of personalized BC but expressed concerns surrounding privacy and safety. Further exploration into the impact of BC on workplace safety and patient satisfaction is needed, and in future exploration, it will be useful to identify which aspects of the business card are most helpful to the patients and use that information to balance the needs of patients and hospitalists. Future iterations of this QI project will explore balancing the needs expressed by patients\u0026mdash;such as having a physical card given to them by their clinician and connecting to their clinician as a human\u0026mdash;and the needs of hospitalists, such as maintaining professional boundaries and ensuring clinician safety from harassment.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate:\u0026nbsp;\u003c/strong\u003eThis project was reviewed by the institution\u0026rsquo;s Protocol Review Oversight Committee and deemed IRB-exempt as a quality improvement project not collecting any personal health information. This article is reported according to the Standards for Quality Improvement Reporting Excellence 2.0 (Squire 2.0) guidelines [7].\u0026nbsp;Both the patients who were interviewed and the hospitalists who completed surveys gave their consent to participate in the quality improvement project and surveys. All information was anonymous, and no patient or hospitalist identifiers were collected.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability Statement:\u0026nbsp;\u003c/strong\u003eThe data that support the findings of this study are not openly available but are available from the corresponding author upon reasonable request. Data are located in controlled access storage at VCU Health System.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e No funding for this project.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number:\u003c/strong\u003e not applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHuman ethics and consent to participate declarations\u003c/strong\u003e: not applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eArora V, Gangireddy S, Mehrotra A, Ginde R, Tormey M, Meltzer D. Ability of hospitalized patients to identify their in-hospital physicians. 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SQUIRE 2.0 (\u003cem\u003eStandards for QUality Improvement Reporting Excellence)\u003c/em\u003e: revised publication guidelines from a detailed consensus process: Table 1. BMJ Qual Saf. 2016;25(12):986\u0026ndash;992. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1136/bmjqs-2015-004411\u003c/span\u003e\u003cspan address=\"10.1136/bmjqs-2015-004411\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDyrbye LN, West CP, Sinsky CA, et al. Physicians\u0026rsquo; Experiences With Mistreatment and Discrimination by Patients, Families, and Visitors and Association With Burnout. JAMA Network Open. 2022;5(5):e2213080. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1001/jamanetworkopen.2022.13080\u003c/span\u003e\u003cspan address=\"10.1001/jamanetworkopen.2022.13080\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eO\u0026rsquo;Leary KJ, Kulkarni N, Landler MP, et al. Hospitalized patients\u0026rsquo; understanding of their plan of care. \u003cem\u003eMayo Clin Proc\u003c/em\u003e. 2010;85(1):47\u0026ndash;52. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.4065/mcp.2009.0232\u003c/span\u003e\u003cspan address=\"10.4065/mcp.2009.0232\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-social-science-and-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"diss","sideBox":"Learn more about [Discover Social Science and Health](https://www.springer.com/journal/44155)","snPcode":"","submissionUrl":"","title":"Discover Social Science and Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Patients responded well to a personalized business card (BC) from their hospitalists, finding it helpful in their care experience. While hospitalists supported this initiative, they raised concerns about privacy and safety. Future efforts will focus on understanding how BCs impact workplace safety and patient satisfaction, as well as identifying the most valuable aspects for patients while balancing the needs of hospitalists","lastPublishedDoi":"10.21203/rs.3.rs-6428714/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6428714/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBusiness cards show promise as an intervention to improve rapport between clinicians and patients but have not been well-studied in clinical practice. We trialed business cards with a group of hospital medicine clinicians on one inpatient medical unit and measured the impact to clinicians and patients. Overall, hospitalists supported the intervention, though they raised concerns about the more personal elements on the cards. Female physicians had greater concerns than male physicians. Patients found the cards useful, and there was in increase in the percentage who could identify their own physician, though improvements in their knowledge of hospital medicine was not noted. Patient satisfaction with \u0026lsquo;Communication with Doctors\u0026rsquo; improved during the time of the intervention. Business cards appear to be an acceptable and feasible intervention for improving rapport between patients and healthcare clinicians. More study is needed to identify how to structure business cards to meet patient and hospitalist needs.\u003c/p\u003e","manuscriptTitle":"Hospitalist Barriers to Using a Personal Business Card","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-14 11:33:06","doi":"10.21203/rs.3.rs-6428714/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-05-24T07:39:23+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-24T07:38:29+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-21T21:21:13+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"335228518044989678036788818246118255840","date":"2025-05-20T21:26:35+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-15T18:12:45+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"151882434986323526364531164806622395063","date":"2025-05-15T17:35:32+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-05-07T15:35:46+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-05-07T15:29:18+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-05-05T16:35:11+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-05-02T14:05:15+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Social Science and Health","date":"2025-05-02T14:04:10+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-social-science-and-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"diss","sideBox":"Learn more about [Discover Social Science and Health](https://www.springer.com/journal/44155)","snPcode":"","submissionUrl":"","title":"Discover Social Science and Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"1aae5b56-ff84-43a7-9702-f45d344783c9","owner":[],"postedDate":"May 14th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-08-29T13:23:14+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-14 11:33:06","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6428714","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6428714","identity":"rs-6428714","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}