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Primary Care Practice dropping hospital admiting privileges...Talk us out of it...

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  • #16
    I was not sure what was discussed until I read the thread title.

    It is 2019 - which primary care takes care of their own patients in the hospital anymore. It is a cause of burnout. Better to stay in the office and see more patients in the wasted time spent traveling back and forth to the hospital.

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    • #17




      I was not sure what was discussed until I read the threat title.

      It is 2019 – which primary care takes care of their own patients in the hospital anymore. It is a cause of burnout. Better to stay in the office and see more patients in the wasted time spent traveling back and forth to the hospital.
      Click to expand...


      We've come across a couple in the last few months who still do it. The ones that don't tend to advertise it as a benefit which pays less for the added convenience.  You can either do 25% inpatient for $X or 100% outpatient for $X - $Y.

      Not meaning to hijack OP's thread, but I guess my question for those who have some experience with this is - Any truth to that logic?  If productivity goes up due to the change, I'd think everyone is making more money all the way around.  Would you accept a lower base salary for 100% outpatient?
      I should have been a pair of ragged claws. Scuttling across the floors of silent seas.

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      • #18
        Update: We have notified the hospital that we are pulling out. Times change. When my partners and I started out, being classical trained internists, we did everything from bone marrows, liver biopsies and temporary pacemakers. Now as my hearing decreases I don't hear the S3 gallops anymore (Just get a BNP and an echocardiogram).

        Thanks for confirming what I have known for some time. In retrospect wish we had done so five years ago.

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        • #19







          Wait… do you have to have hospital privileges for your malpractice insurance? If so,  we have a “outpatient medicine” privileges that are not required to come into the hospital. It still means you have to go to meetings, etc. but you get to keep your malpractice insurance. Just make sure….
          Click to expand…


          Thanks. Will look into it.

          BTW, did you get a lower rate on malpractice dropping going to,hospital?
          Click to expand...


          I still have hospital privileges however anytime there is a scope change, especially to less risky patients, rates typically drop.

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          • #20
            As an outsider looking in, I can see how it would be nice if a concierge primary care practice still had some "ownership" and advocacy if I were admitted to the hospital.  However, it seems pretty preposterous that this would be expected (at little or no pay!) if someone weren't paying extra to be part of a smaller concierge patient panel.

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            • #21
              You should have done that years ago. Congrats on a better lifestyle!

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              • #22
                We have about 2 dozen PCPs that still admit their own pts. In fact, we had 3 new PCPs starting this year that will do their own admissions. But it's getting increasingly rare, and we are starting to offload them somewhat (taking overflow, vacation coverage, etc). You need a well-trained nursing staff and good EMR (not Meditech) in order to make it work. I have nothing but profound respect for those that can.

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                • #23
                  hospitalists vs pcp admitting patients is an interesting question-10 years ago.   There is enough evidence out there that tells that pcp's should not be admitting their own patients while seeing patients in the office.   It is incredibly inefficient- whereas the pcp has to sleep at nighttime to see his clinic patients the next morning and has patients scheduled while patients are developing chest pain in the hospital, hospitalists are unencumbered by these limitations.   People always underestimate the amount of time it takes to carve out a plot of time, step out of the office, get into the car, drive the hospital parking lot, walk into the ward where your patient is located, then write your note, then go back into the car and drive back to the office.  That is like an hour even if your hospital if 5 minutes away.

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                  • #24
                    Meditech is reason enough to stop admitting. Gosh

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