FP Report -- March 1999
Inpatient physicians' association pushes voluntary (not mandatory) use of hospitalists
NelsonTwo years ago, generalists worried they'd be forced to leave their patients at the hospital door, surrendering them to a hospitalist's care.
By now, the paranoia has pretty much subsided.
Why? Perhaps because the number of hospitalists hasn't surged. And perhaps because several groups insist hospitalist systems should not be mandated.
"The National Association of Inpatient Physicians supports voluntary implementation of hospitalist programs," said internist John Nelson, M.D., of Gainesville, Fla., a cofounder of the NAIP. "Patients and physicians should be able to choose hospitalist systems or not."
Nelson acknowledged doctors' misgivings about giving up hospital care to hospitalists. "I understand how that may be a concern for AAFP members, when, about 30 years ago, they were struggling to get hospital admitting privileges," he said.
He added, "Some may believe the NAIP is a union of hospitalists out to kick other doctors out of the hospital. That's wrong. We just want to rub elbows with people who do the same kind of work we do."
The NAIP, affiliated with the American College of Physicians-American Society of Internal Medicine, began taking dues-paying members last April and counts about 750 in its ranks, including family physicians.
Nelson estimated about 5 percent of the country's 3,000 or so hospitalists are family physicians. Ads in medical journals indicate demand for more hospitalists.
NAIP's position on voluntary use of hospitalist systems is similar to policies of the AMA and AAFP. (For AAFP's position, see story on task force, page 4.)
All of which hasn't stopped some HMOs from requiring the use of hospitalists. For example, Group Health Cooperative, based in Seattle, Wash., said in an AAFP survey last year that its only type of inpatient care management was the mandatory use of hospitalists.
Group Health was the only one of the 15 HMO survey respondents with mandatory use of hospitalists as its sole option for managing inpatient care. But almost half of the respondents had or were considering having at least one site where primary care physicians must use hospitalists.
Note: Information on the NAIP and its April 21 meeting in New Orleans is available at www.naiponline.org or (800) 843-3360.
FP Report is published by the AAFP News Department. Copyright © 1999 by American Academy of Family Physicians.
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