Physicians oppose required use of hospitalists

24 groups join to protest new staffing plan

A coalition of physician groups is calling for an end to the mandatory hospitalist programs required by some managed care companies.

The managed care plans are denying patients the right to have their personal physician care for them in the hospital by establishing mandatory hospitalist programs, says a letter sent to managed care organizations by the American College of Physicians-American Society of Internal Medicine in Washington, DC, and 23 other physician groups.

Mandatory hospitalist programs require that a patient’s regular physician transfer complete responsibility for patient care to a hospital-based physician. The policy prevents primary care physicians from either admitting patients or caring for them after they are admitted.

Managed care companies in Florida, Maryland, Missouri, and Texas have established mandatory hospitalist programs. "Mandatory hospitalist programs are bad public policy, just as they are bad for individual patients," says the protest letter sent to the American Association of Health Plans, the Blue Cross, Blue Shield Association, CIGNA HealthCare, and Prudential Health Care.

"Patients must have the opportunity to discuss the potential advantages and disadvantages of the hospitalist programs with their physicians and be free to choose," the letter says.

The groups don’t oppose hospitalists as long as their use is voluntary, says Harold Sox, MD, professor of medicine at Dartmouth School of Medicine in Hanover, NH.

In addition to ACP-ASIM, the letter was signed by medical associations, academies, and societies.