About hospitalists:
'What's the big deal?'
The AAFP Congress of Delegates adopted two statements on hospitalists Sept. 16: principles for inpatient care management ("hospitalist" systems) and guidelines for communication between hospitalists (some may be FPs) and other physicians in the community.
Virgilio Licona, M.D., of Denver testifies during the Reference Committee on Public Policy regarding the issue of non-compete clauses by community health centers accepting federal funding. The Congress of Delegates later voted to oppose such restrictive covenants. Behind Licona, AMA President Nancy Dickey, M.D., waits her turn to speak.The statements say the use of hospitalists should be voluntary for both the referring physician and the patient. And there is a downside: Family physicians who relinquish hospital privileges may later have difficulty reapplying for privileges and getting credentialed by managed care organizations.
The guidelines call for the inpatient physician to have timely communication with the patient's family physician -- extremely important when the patient has a change in status, complications or a new diagnosis.
Testifying at a reference committee hearing Sept. 15, (then) AAFP Director Bruce Bagley, M.D., of Albany, N.Y., downplayed any controversy about hospitalists. On Sept. 14, Bagley had visited the family practice inpatient service at San Francisco General Hospital, staffed by residents and directed by FP Ronald Goldschmidt, M.D. "The residents are in constant contact with family physicians in the community," Bagley told the reference committee. "If there's a change in the patient's status, the residents are on the phone immediately."
Bagley, who chaired the AAFP Task Force on Hospitalists, suggested that Goldschmidt write an article on the residents' communication with the community family physicians. "I am," said Goldschmidt. So Bagley suggested, "'The title of the article needs to be, 'What's the Big Deal?'"
In addition to adopting the principles and guidelines, the Congress referred to the Board a resolution on hospitalist issues. Among the issues: Family practice residents must keep receiving full, undiminished training in the care of hospital patients.
