Can I practice both in-patient and out-patient care as a general internist?

[alberrito]

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Hi,

My question is as titled. The reason I'm asking is because in my home country, and many places outside of the US, there is no pure in-patient "hospital medicine" and therefore no "hospitalists." I can see the attractiveness of being a hospitalist with the good money and lifestyle if you don't mind working every other weekend (which I do), but I feel like I would want to have some variety in my work by going to clinics and admit my own patients onto my in-patient service when conditions require so. Also, i'm not a fan of the 7-on-7-off schedule as I currently understand it because of the discontinuity of care due to hand-offs that occur every week. i.e. If a patient is required to be hospitalized for 9 days it's possible that he will see 3 different hospitalists during his stay, and this could be detrimental in a few ways.
I guess i digressed a little bit, but can anybody tell me if there are internists in the US who provide both in-patient and out-patient care on a daily basis?

Thank you and I look forward to your inputs!

 

[Handsome88]

I can't see why not. You can pretty much do whatever you want. Hell I've seen IM docs work in emergency departments and ICUs.

 

[danebrennan]

There are plenty who practice that way in the rural Midwest where I live.

 

[alberrito]

Thx for ur responses. So would these docs be on private contracts with the hospital or in a hospitalist group?

 

[flipmd]

Thx for ur responses. So would these docs be on private contracts with the hospital or in a hospitalist group?

These docs mostly join a group practice, and the group practice admits patients to the hospital. The group practice usually is supported by the hospital in some form or another, especially during startup.

Mostly family practice groups do this (see inpatients and outpatients), but there are still some traditional IM groups who do it but it's becoming rarer in urban areas. Some models have you seeing your own patients in the hospital M-F, and someone on call from your group will see them on the weekends. Night admissions are usually handled by the ER with placeholder orders after talking to whoever's on call at night, for the primary PCP to see during the day. If you're worried about handoffs and such, this model can still have 3 physicians for a 9-day stay (2 different weekenders if it's not you, plus you M-F).

 

[jdh71]

Yes