HOSPITALISTS: Kansas MDs Reject Program, Force Change
As hospitalist programs around the country pick up speed, the objections of primary care physicians in Kansas last month prompted a policy change in the Blue Cross and Blue Shield of Kansas City program mandating "a designated physician to take over Blue Cross HMO patients' care once they've been admitted to the hospital from the emergency room." Hospitalist programs have gained popularity recently, spurred by recent studies indicating that the patients participating in the inpatient care specialist programs had lower medical care costs and shorter length of stays. But despite cost efficiencies, critics note a primary shortcoming -- the loss of continuity of care. Dr. Stephen Vilmer, president of the Missouri State Medical Association, expressed concern over the program in "a scathing letter to Blue Cross" dated Nov. 17, which he copied and sent "to nearly every state and national medical organization ... as well as Missouri's attorney general and insurance department director." Under the program, which began this month at North Kansas City Hospital, patients admitted to the hospital from the emergency room were routinely assigned to a hospitalist to oversee their care. In his letter, Vilmer charged that the hospitalist program represents "an egregious invasion of the doctor-patient relationship." The letter prompted a revision of the program; now primary care doctors can opt to participate in the program or maintain oversight of their patients' care themselves (Dasbach, Kansas City Business Journal, 11/30). Click here for past CHL coverage of hospitalists.
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