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Hospitalist Systems of Inpatient Care Management
- The opportunity to participate as a "hospitalist" in such systems must be open to all interested physicians whose education, training and current competence qualify them to serve effectively in this role.
- The decision of who should care for a family physician's hospitalized patients should be made by the patient and his or her family doctor, in the interest of what is best for patient care (i.e., participation in hospitalist models should be voluntary).
- In the interest of preserving continuity, patient advocacy and health care decision-making which is in concert with the patient's values, the AAFP strongly encourages the use of "generalists" for inpatient general medical management. Consultation with an intensivist or medical or surgical subspecialist does not preclude the need for the continuing, comprehensive and personal care provided by a "generalist" physician.
- In the event that family physicians elect to refer their patients for inpatient care management, the AAFP strongly encourages them to maintain open communications with those patients and their families throughout the hospitalization, as recommended in the "AAFP Guidelines for Interaction in 'Hospitalist' Models."
- While family physicians may elect to refer their patients for inpatient care management, the AAFP cautions that they should strongly consider the mid- and long-range implications for their practices before they relinquish hospital privileges. Such implications may include
- difficulty being credentialed and/or reimbursed by managed care companies for services/procedures in the ambulatory setting if one does not have hospital privileges for those same services/procedures, and/or
- the very real possibility of being unable to successfully reapply for hospital privileges at future points of career transition, without the necessity of seeking substantial additional education and retraining.
- The AAFP will develop ways to help support members when the opportunity to provide hospital care has been removed by their health care system or managed care organization.