HOSPITALISTS: Physician Backlash Grows
The AP/Ft. Worth Star-Telegram reports that the debate between doctors and insurers over the use of hospitalists is intensifying, as some doctors begin to resist the practice. Insurers that make use of hospitalists, most notably Prudential Inc. and Humana Inc., claim that "patients tend to get more attention from hospitalists since the doctors aren't splitting their time between the hospital and an office. As a result, tests are scheduled faster and patients often go home sooner without care being compromised." Humana spokesperson Greg Donaldson said a study of the company's experience with hospitalists in Kansas City found that they "shortened some hospital stays by half, and increased the likelihood that patients were prescribed appropriate medications." Humana also says its hospitalists receive an 85% satisfaction rating from their patients. Dr. Kirk Cianciolo, Prudential's senior medical director in South Florida and Tampa, said, "We are trying to improve efficiency in the hospital and improve quality and as a result hopefully save some costs." But some doctors and consumer groups are outraged at what they see as a breach in the doctor-patient relationship. Ron Pollack, executive director of Families USA, said, "There is incredible irony in this. HMOs have for the last few years talked about the virtue of having a primary care physician who coordinates the care for a patient, and yet at a point when the patient most is in need of health care, they are withdrawing the central feature ... by the doctor who knows the patient best." Dr. Cornel Lupu, a Miami internist and Prudential primary care doctor, said, "This is a direct attack on our profession. It's a horrible idea." But industry experts say as hospitalists are particularly efficient in shortening hospital stays, its only seen the tip of the iceberg. Brett Turner, a health care consultant with Hamilton-HMC, said, "More and more plans are considering making it a mandatory program. It's a major trend, a much more efficient way to practice quality medicine. But making the transition is a difficult process for some" (Galewitz, 5/3).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.