Letters to the Editor

Comment on the Family Physician as Hospitalist



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Am Fam Physician. 2000 Feb 1;61(3):647.

to the editor: I read with interest the letter on the role of the family physician as a hospitalist.1 I joined a practice in Washington, N.J., in 1984, but well before that, this group of physicians had been rotating hospital care of patients on a weekly basis. The rotation continues, and the physician on hospital duty has only the hospital as the primary responsibility for that assigned week. We do not have the inherently disjointed coverage problems because we do not share on-call arrangements with other practices. The physician on call handles all the admissions for that week, as well as all the calls for the practice at large. At the office, we have extended hours of operation that include Saturday hours, so the calls generally do not become onerous.

I could not agree more with Drs. Guyn. As a rule, our patients are pleased with their inpatient care. The on-call rotation exposes our patients to other members of our practice. This improves our outpatient care by increasing patient identification with the group and not just with one physician. It also reminds the physicians that this is a group practice—continuity is preserved.

The hospitalist movement has appeared under the shadow of managed care. Attempting to reach goals of hospital days per 1,000 insured lives of less than 200 days per year brings with it concern for the present process of inpatient care. Decreasing use of hospital services will increase outpatient care. In the future, who will feel adequately trained and experienced to handle the smaller number of patients on our inpatient services? The future may reveal a shared physician caring for the inpatients of several practices.

REFERENCES

1. Guyn J, Guyn T. The family physician as a hospitalist [Letter]. Am Fam Physician. 1999;60:502–3.

Send letters to Kenneth W. Lin, MD, MPH, Associate Deputy Editor for AFP Online, e-mail: afplet@aafp.org, or 11400 Tomahawk Creek Pkwy., Leawood, KS 66211-2680.

Please include your complete address, e-mail address, and telephone number. Letters should be fewer than 400 words and limited to six references, one table or figure, and three authors.

Letters submitted for publication in AFP must not be submitted to any other publication. Possible conflicts of interest must be disclosed at time of submission. Submission of a letter will be construed as granting the American Academy of Family Physicians permission to publish the letter in any of its publications in any form. The editors may edit letters to meet style and space requirements.


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