A recent article from the New England Journal of Medicine suggests the current division of labor between hospitalists and primary care physicians (PCPs) needs to be reconsidered.
The article recommends that any alternative approach must respect the achievements of the current system, such as reduced lengths of stay, better inpatient care, better educators in teaching hospitals, and the creation of primary care medical homes.
Their proposed alternative system has the PCP working as a consultant within the hospital team. The PCP would visit within 12-18 hours after admission to support and counsel patients and their families while consulting with the hospital team. They would then write a consultation note, noting history and recent testing and make recommendations for personalized inpatient evaluation and management.
Though, the article points out, there are some barriers to implementation, such as the time component for the PCP, the workflow of the hospitalist and payment reform in relation to office visits. These issues would need to be addressed by both the PCP and the hospitalist in order to form a successful relationship that is beneficial to the patients.
