Relationship Between Hospital-Based and Private Practice Physicians

Abstract

For a number of reasons, hospitals appoint full-time and part-time physicians to practice medicine within the hospital or its outlying divisions. Such physicians provide a wide variety of primary, specialty, and subspecialty services. Among other advantages for hospitals are a potentially tighter reinon quality control and an increased bed occupancy and revenue at a time when financial issues have become increasingly important. Physicians engaged solely in administration or research rarely pose a problem in the relationship between the hospital and private practice physicians. However, it is more likely that friction (which might adversely affect patient care) may occur when there is overlapping of services provided by the private practice physicains and the hospital-based physicians, whether they are salaried by the hospital or on a fee-for-service basis. Therefore, the Committee on Hospital Care of the American Academy of Pediatrics offers the following guidelines concerning this interface. ROLE OF HOSPITAL-BASED PHYSICIANS The Committee on Hospital care believes that many appropriate roles exist for hospital-based physicians. Certain specialties may advantageously be hospital based, or regional hospital units are involved. Such specialists might include (among others) those involved in burn care, spinal cord injuries, dialysis, cardiac surgery, emergency medicine, pediatric and neonatal intensive care, medical education, radiology, pathology, and anesthesiology. Certain hospital units benefit from continual organization and supervision which may best be provided by hospital-based physicians. The Committee believes that research and teaching (including primary care teaching) must be maintained in certain hospitals. Commonly, these programs are centered around hospital-based physicians, although private practice physicians have participated productively in most programs.