Hospitalist trend gets Academy attention
Buoyed by members' interest and divergent opinions, the Academy continues to look at the trend toward hospitalists and how it might affect the future of family practice.
Director Bruce Bagley, M.D., who chairs the Academy's Task Force on Hospitalists, said he's found the controversy over designated inpatient physicians to be less than cut and dried.
"The trouble is, the hospitalist trend is a mixed bag," said Bagley, of Latham, N.Y. "Some members who use hospitalists are thrilled by the idea of being free from hospital rounds. Others are afraid family physicians will be excluded from hospital care."
The task force, which was created at the urging of AAFP President Neil Brooks, M.D., of Rockville, Conn., met in January and presented its list of recommendations to the Board in March.
Among the recommendations approved by the Board was the distribution of a free informational report -- including a monograph from the California AFP -- to interested members. Academy members can get a copy of the report by calling the order department at (800) 944-0000 and requesting item #R718.
"I want to caution concerned members that the hospitalist idea is not a monolithic trend," said Bagley. "There are many hospitalist models being tested, including one in Boston where a family practice department has a hospitalist rotation made up of internists and family physicians."
Bagley also cited the example of four family physician partners who choose to rotate hospital coverage of the practice's patients by spending one week out of four in the hospital.
"This is something that's been going on for decades; it's just been given a new definition," said Bagley.
In the report, the task force outlined major issues of concern to the AAFP, including the impact of hospitalists on:
- quality of patient care,
- professional/lifestyle issues,
- the mandatory vs. voluntary nature of such a system,
- reimbursement and health care resources,
- patient satisfaction, and
- professional interaction and continuing medical education.
The Board also approved funding a sample survey of AAFP members to determine how the hospitalist idea is affecting FPs and their patients nationwide. The survey will include questions concerning the degree of participation in a hospitalist system, whether FPs are being excluded from the experimental models, and the degree to which physician choice is resulting in relinquishing inpatient privileges.
The hospitalist task force will continue to collect information for the 1998 Congress of Delegates, Sept. 15-17 in San Francisco.
FP Report is published by the AAFP News Department. Copyright © 1998 by American Academy of Family Physicians.