Outpatient Family Medicine

[Howard7]

Just was wondering if any of you guys can settle a debate. One of my best friends in college is a family medicine resident. He claims that with the hospitalist movement that there are outpatient only family medicine practices that take zero call.

Is this correct? Also, how common are outpatient only practices. It seems to me that if the hospitalists do take all of the admissions from the ER docs that family medicine doctors do not need to take call.

Also, how common are family practice physicians in big cities. I've always thought that internists, pediatricians, and/or ob/gyn doctors had the market share in big cities (such as miami, atlanta, san diego etc).

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[deleted87716]

Since you PM'd me this question as well, I'm pasting my reply to your PM in the thread.

With the emergence of the hospitalists, has there been an increase in outpatient only practices?

Yes. Many primary care physicians have stopped going to the hospital because of economic and lifestyle factors.

do you have to pay a hospitalist to take all of your admissions.

No.

For places without hospitalists, I read that you have a home beeper call. What if they need to be admitted by the ED. Do you have to come into the units to do HanP's admission orders during the night.

All physicians need to provide some form of after-hours coverage, either themselves or as part of a call group. If you admit patients to the hospital, you will sometimes have to do so in the middle of the night. There's no getting around that. If you don't go to the hospital, call is essentially phone triage.

Are reimbusement for ultrasound and cosmetic procedures the same for FM doctors and dermatologists.

Ultrasound and other covered services are reimbursed the same under Medicare. However, private insurers can have different negotiated fee schedules with different physicians, assuming it's to their advantage to do so. Cosmetic services are typically not covered by insurance, so you can charge whatever the market will bear.

how common is it for a family doctor to work in a big city like san diego, denver, miami etc.

Large cities typically have lots of doctors, including family physicians.

Are the politics tougher in big cities since they might have internal medicine, pediatrics, or Ob to cover the hospital?

If you're talking about issues related to privileges, these are generally facility-specific. It's not just a "big city" issue.