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Back to the future?

April 2015

Published in the April 2015 issue of Today’s Hospitalist

It seems like it wasn’t that long ago that hospitalists were hard at work convincing primary care physicians to stay away from the hospital. The specialty was new, and PCPs felt like they were abandoning their patients if they didn’t come to the hospital themselves.

Flash forward 10 or 15 years, and very few PCPs ever step foot in a hospital any more. As a specialty, hospital medicine has won the struggle to gain the acceptance of PCPs and specialists alike.

Now that hospital medicine has vanquished PCPs in the inpatient setting, it may come as a surprise that at least some in the specialty are thinking about how to bring those same physicians back.

Hospitalists have long looked for better ways to communicate with primary care doctors to minimize the effects of handoffs and to improve post-discharge care. But as our cover story explains, a small group of hospitalists thinks that one good solution is to get outpatient physicians’ input on their hospitalized patients. Some are even exploring ways to pay PCPs for their services inside the hospital.

Bringing primary care physicians back “as consultants to hospitalist attendings “and exposing hospitalists to the way they think is an interesting idea. Few hospitalists have ever seen a PCP on the wards, and a growing number have no experience working in the outpatient setting. As a result, the disconnect between hospitalists and primary care physicians will likely continue to grow.

Will PCPs ever return to the hospital en masse? I doubt it, but it seems like a good thing that hospitalists are talking about better ways to connect with their outpatient colleagues. It’s not only good for patient care, but for the future of hospital medicine.

edoyleEdward Doyle
Editor & Publisher
edoyle@todayshospitalist.com