February 2000 • Volume 6 • Number 2
Privileges down, office procedures up
BY JANE STOEVER
Surveys of family physicians show a shift away from certain hospital privileges and toward office procedures (see chart below).
The transition mirrors the overall change to more outpatient care as cost-cutting efforts grind on and office-friendly technology booms.
Physicians and administrators still ask the AAFP Socioeconomics Division for background papers on various procedures as part of family practice. Requests about ambulatory care are on the rise.
However, statements on OB privileges continue to top the list of back-up information family physicians seek.
"It always comes down to economics," says Jane Krieger, R.N., J.D., assistant director of the division. "Whether or not a family doctor has difficulty getting OB privileges depends on how many OB-Gyns are in competition with family physicians in a given area."
The percentage of AAFP active members doing routine OB deliveries plummeted from 37 percent in 1980 to 28 percent in 1990 and slipped to 24 percent by 1999.
Studies suggest family physicians drop OB care mainly because of its lifestyle constraints. According to a 1999 AAFP survey, 77 percent of members without routine OB privileges didn't want them, 6 percent found liability coverage too high and only 0.7 percent had been denied privileges.
Note: If you need help in obtaining any hospital privileges, call the Socioeconomics Division at (800) 274-2237, Ext. 4162.
Percentages of AAFP active members who have hospital privileges/offer office procedures
Hospital privileges 1990 1999 OB -- routine delivery 28% 24% Caesarean section 10% 7% Surgery assisting 45% 33% ICU 75% 67% Flexible sigmoidoscopy 39% 33% Colposcopy 9% 18%
Office procedures 1990 1999 OB ultrasound 8% 11% Cardiac stress test, treadmill 12% 11% Flexible sigmoidoscopy 40% 46% Colposcopy 12% 35% Source: AAFP Practice Profile Surveys
FP Report is published by the AAFP News Department.
Copyright © 2000 by American Academy of Family Physicians.
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