Any PCPs treat their patients in the hospital?

[CircadianRhythm]

I'm just curious as a pre-med interested in primary care if any PCPs are treating their regular patients in the hospital? I know now the trend is for primarily outpatient practices that refer to hospitalist groups, but are their rural groups that still admit their own patients? What's the lifestyle like? Is it a financial hit or not?

My grandfather was an oldschool GP and did this and I always thought itd make for a rewarding career to practice medicine in this traditional way. He's dead though so I cant ask him about it lol. My mom is an internist and used to do this right out of residency but said the workload was intense. She's been doing out patient only for 20+ years now and said she is no longer familiar with these types of arrangements.

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[polylux]

Yes, it happens. I used to work in a decently sized city where many PCPs admitted their own patients to the hospital. However, I would say they are in the minority.

 

[Awesome Sauceome]

Yea that's bigger for rural for sure.

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[LostInPreMed]

I'm just curious as a pre-med interested in primary care if any PCPs are treating their regular patients in the hospital? I know now the trend is for primarily outpatient practices that refer to hospitalist groups, but are their rural groups that still admit their own patients? What's the lifestyle like? Is it a financial hit or not?

My grandfather was an oldschool GP and did this and I always thought itd make for a rewarding career to practice medicine in this traditional way. He's dead though so I cant ask him about it lol. My mom is an internist and used to do this right out of residency but said the workload was intense. She's been doing out patient only for 20+ years now and said she is no longer familiar with these types of arrangements.

I worked in a small community hospital in the foothills of Northern California and about half of the docs that admitted patients from the ER into the hospital, were private practice physicians with their own practice. Additionally, some PCPs would only admit their own patients, but never took call.

One of the reasons it is no longer common to do both is because working in the clinic all week, then admitting patients all weekend, then going back to the clinic the following, made for very long hours.

 

[turnitblue&blue92]

I live in Greensboro, NC ( population 300,000 +). Most of the doctors at an Internal Medicine Practice I shadowed at still takes care of their patients who are in the hospital. From what I gather, the increased workload is demanding , but the patients who are treated by their PCP tend to stay in the hospital for a shorter period of time. This practice also has the ability to directly admit their patients from the ER, and in some cases they instruct the patient in proper management of the condition at home ( since they are familiar with the patient's medical history), thus preventing hospital admissions and higher health care costs. Because of this insurance companies will "bonus" these physicians for reducing overall costs. Additionally, the patient satisfaction is high since they are taken care of by their personal physician ( or at least one of the practice members) if they are hospitalized. Admitting done on nights and weekends is taken care of by the doctors on call. So, yes the doctor on-call will be woken up a 2:00AM and will have to drive to the hospital to assess the status of the patient. The doctors will typically round on their patients weekday mornings before seeing the patients in the clinic. Nevertheless, about a year or two ago, two of the doctors decided to stop providing in-patient care because it was just too demanding. These doctors also inherited the most of their patient load from retired colleagues, therefore , compared to the past and their co-workers, they were seeing twice to three times as many patients in the hospital since most of their patients were older. This practice is one of the few remaining physician-owned private practices in Greensboro.

 

[abolt18]

My home town (around 80,000) had plenty of family docs that could admit their own patients, rounded on their patients, and handled all of their hospital care.

 

[austintr]

As you've seen already, it's very much a case-by-case basis. Nearly all of the docs I have worked with in my hometown in KS (~14,000) admit their own patients, do their own rounds, etc. Mainly because a smaller patient base allows them to split time at their office and the hospital, and they're generally hardworking people by nature, as the area is fairly rural. However, in the larger college town (~60,000) I'm working in now, there are maybe two docs out of roughly 30-40 that admit their own patients. Hospitalists manage nearly all inpatients, and from what I have seen and heard, hospitalists are going to soon rule that realm in areas that can sustain them. Keep in mind that in the smaller town, when the ER wasn't staffed by mid-level provider's (PA's, ARNP's, etc.) it was run by family practice docs moonlighting in emergency medicine. Hope this helps!
TL;DR: Rural area hospitals operate far differently from larger hospitals, so it really depends on where you practice.