I think there is a big difference between routine post-op care and having another team following along both from a monetary and ethical standpoint.
As a surgeon, your fee includes pre-op through the end of the global period (for major surgeries up to 30 days post-op). This includes all the rounding, office visits, etc. (with some exceptions that I won't go into right now). To routine turf out things you can handle is then a little suspect reimbursement wise. The model for this is the splitting of the global fee between ophthalmogists and optometists when one does the operation and the other does the post-operative care (last I checked, it got split 80/20, but that probably has changed)
Likewise the American College of Surgeons has defined a code of conduct which I will list below.
Now I think having another team (e.g. a severe CHF patient that has a cardiology team or their general internist that knows them following, etc.) is probably encouraged. And perhaps if the resources were available, having a general internist that knows them keeping an eye out for other issues that might not rise to a surgeon's notice would not diminish care. However, it is still ultimately the surgeon's responsibility to monitor the overall well-being of the patient. His or her operation is going to cause a certain amount of physiologic insult and it is the surgeon who was in doing the operation that knows what the level of concern should be. To voluntarily walk away wholly from the patient and wait to be called back is probably to be derelict in duty, unless you can arrange to have another person of equal knowledge to cover you (e.g. when you are on vacation). Having said this, I do know of a number of private practice surgeons that do use internists for their routine medical care of their post-operative patients, only managing the drains and diet and wounds.
From:
http://www.facs.org/fellows_info/statements/stonprin.html#anchor173119
E. Postoperative Care
The responsibility for the patient's postoperative care rests primarily with the operating surgeon. The emergence of critical care specialists has provided important support in the management of patients with complicated systemic problems. It is important, however, that the operating surgeon maintain a critical role in directing the care of the patient. When the patient's postoperative course necessitates the involvement of other specialists, it may be necessary to transfer the primary responsibility for the patient's care to another physician. In such cases, the operating surgeon continues to be involved in the care of the patient until surgical issues have resolved. Except in unusual circumstances, it is unethical for a surgeon to relinquish the responsibility for the postoperative surgical care to any other physician who is not qualified to provide similar surgical care.
If the operating surgeon must be absent during a portion of the critical postoperative period, coverage should be provided by another surgeon who is skilled and who can render surgical careincluding reoperation, if necessaryequivalent to that provided by the surgeon who performed the operation. The patient should be informed about this arrangement in advance.
The surgeon's responsibility extends throughout the surgical illness. When this period has ended, it is appropriate for the surgeon to relinquish the responsibility for management of the patient. When a patient is ready for discharge from the surgeon's care, it may be appropriate to transfer the day to day care to another physician.
