With hospitalists taking on larger roles and more and more primary-care practices being taken over by hospital systems, tensions between primary-care physicians and hospitalists over the proper course of treatment for primary-care physicians’ hospitalized patients can be intense and the communications gaps wide.
Cheryl Pegus, M.D., director of the Division of General Internal Medicine and Clinical Innovation at New York University Langone Medical Center, touts open communication and coordinated care by the two groups in this video.
Bu in their Medscape comments about Dr Pegus’s upbeat video, frustrated physicians indicated that the nice things, including professional collegiality, she describes are not yet the reality they experience.
Text and video: Cheryl Pegus, M.D., director of the Division of General Internal Medicine and Clinical Innovation at New York University Langone Medical Center, discusses how to improve the relationship between primary-care physicians and hospitalists; the latter are the fastest growing specialty physicians in the U.S.
She notes that with that growth, “Over the past 5 or 10 years, we’ve also seen another trend. Academic medical centers, hospitals, and community health systems have been purchasing outpatient practices of ambulatory physicians. Today, about 58 percent of family medicine physicians and 50 percent of internal medicine physicians are employed by health systems. We also see this with multi-specialty practices, where about 40 percent of them are associated with health systems and about 20 percent are associated with single-specialty hospitals. Today, we have a number of our physicians who are employed in both the inpatient and outpatient settings.”
Among her other remarks:
“There are many advantages to having outpatient ambulatory sites and inpatient physicians having patients’ care on the same patient portal where the patients also have access to the system. Some of the benefits include that there is a patient history readily available. You actually know who the physicians are the patient has seen from a specialty, and from a primary care perspective, and you have their results. You’re aware of the different community resources that a patient has had. This allows beginning an easy communication between physicians, even if they’ve met only once or twice, allowing for easier diagnosis, easier treatment protocols, and transitions back into the community.”
“Because these physicians all work within the same health systems, it’s extremely important that there are great communication modalities set up so that all of the physicians within a health system are hearing the same message. ”
“Electronic medical records form a basis for improving communications between inpatient and outpatient physicians. Putting training into place so that physicians are aware of the tools and how to use them is very important.”