Some specialists think so.
Apparently, some hospitalists are doing their job so well, that they are keeping specialist referrals down. Contrast that to the usual inpatient job by the community physician, where specialists were often consulted for routine problems.
These easy, money-making consults are drying up, leading to burgeoning turf battles: “Some specialists are even accusing the hospitalists of commandeering their patients and admitting them when they themselves should be admitting them as their primary doc. A smaller number of them are just annoyed that the hospitalists exist – since they liked the easy consults from the less comfortable internists who previously admitted unassigned patients.”
Part of the hospitalist’s rationale for existing is their ability to save the hospital money, and that means less referrals. I wonder if the reaction here is common in other hospitals nationwide.
topics: hospitalists, specialists
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- Hospitalists: Good in theory
- Should hospitalists control hospital beds?
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- Should hospitalists or intensivists manage ICU patients?
- Are relationships being lost in medicine, and are hospitalists partly responsible?
- Hospitalists: The last true internal medicine physicians?
- Hospitalists assimilate inpatient medicine, is resistance futile?
{ 2 comments }
Aw come on.
Just because one er doctor anecdotally observes this and writes so on his blog does not mean it is true.
In my community, the hospitalists are consut ordering machines. I feel, as a community attending, that I consult less, probably because I am confident things will b followed up as an outpatient; afterall, I am the one doing the following up.
I find it peculiar how hospitalists go to such lengths to convince others how great they are. Stop with the anecdotes; show me the data. There has not been any valid study that shows hospitalists save money or improve quality in a significant way.
A family practitioner
Hospitalist programs that have become commonplace are very appropriate, desirable and improve quality of care. Most hospitalists are highly qualified physicians who posses the technical training and experience for the job of more severe acute treatment required of most hospitalized patients. To characterize hospitalists as inexperienced rookies is oversimplified and misleading.
There is something to be said for continuity of care and familiarity with clients. Primary care and family physicians are not shut out but encouraged to be part of the team providing input for the hospitalized patient. Good communication between PCP and Hospitalist is beneficial for inpatient as well as the follow-up care after hospitalization. However the reality of practice is most PCP’s gladly defer to the hospitalist because of the time and skills they have to manage the more severely ill patient.
From a broader perspective most people of any age, through a lifetime, rarely need surgery or hospitalization. The large majority of health care is provided as an outpatient in the office setting. Allowing the primary care physician to stay in the office providing more availability to their patients creates greater efficiencies in health care delivery and likely improves quality especially on the inpatient side. This need not be any different than referring to any other specialist to participate in the overall care of a client.
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