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Benefits and Barriers to Adding Inpatient and Obstetrics
For various reasons, over the past several years family physicians have seen their scope of practice dwindle. One such reason is lack of time in their schedule to practice Inpatient or Obstetric medicine. Direct Primary Care allows physicians plenty of time to re-capture a more full-spectrum practice. Many DPC docs take their continuity to the next level by taking care of their patients in the hospital, who can still bill insurance for facility fees (just not professional fees). Many DPC docs deliver babies for a set “global” cash fee, some even practice operative obstetrics.
Reasons many resume inpatient care:
- Value: your patients get more for their money, which helps with recruitment and retention
- DPC docs know their patient better than the hospitalist
- Increases coordination of care and continuity to the outpatient setting
- Doing social rounds? Why not just manage the patient? (Your patients will be texting/calling you from the hospital anyway!)
Barriers to resuming inpatient care:
- Hospital Privileges
- Easiest to maintain current privileges or obtain out of residency harder to get back
- May require board certification
- Occasional turf battles
- Administrators who don’t understand Medicare Opt-In/Out
- May require the attendance of Med-Staff meetings, EMR training use, peer review meetings
- Malpractice Insurance may go up
- Some hospitals only give privileges to their own employees (University hospitals, for instance)
Additional barriers to resuming obstetrical care:
- Many have lost the skills after a prolonged absence from OB, could need to be proctored back, refresher courses, ALSO and NRP training, etc.
- Malpractice insurance may go up high enough it wouldn’t offset money made from doing OB, depending on circumstances such as OB numbers, state of practice and OB malpractice rates, etc.
As with many ways of increasing the scope of practice, using social media and the DPCA membership to identify a mentor with experience is invaluable in achieving these goals.
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Benefits and Barriers to Adding Inpatient and Obstetrics
For various reasons, over the past several years family physicians have seen their scope of practice dwindle. One such reason is lack of time in their schedule to practice Inpatient or Obstetric medicine. Direct Primary Care allows physicians plenty of time to re-capture a more full-spectrum practice. Many DPC docs take their continuity to the next level by taking care of their patients in the hospital, who can still bill insurance for facility fees (just not professional fees). Many DPC docs deliver babies for a set “global” cash fee, some even practice operative obstetrics.
Reasons many resume inpatient care:
- Value: your patients get more for their money, which helps with recruitment and retention
- DPC docs know their patient better than the hospitalist
- Increases coordination of care and continuity to the outpatient setting
- Doing social rounds? Why not just manage the patient? (Your patients will be texting/calling you from the hospital anyway!)
Barriers to resuming inpatient care:
- Hospital Privileges
- Easiest to maintain current privileges or obtain out of residency harder to get back
- May require board certification
- Occasional turf battles
- Administrators who don’t understand Medicare Opt-In/Out
- May require the attendance of Med-Staff meetings, EMR training use, peer review meetings
- Malpractice Insurance may go up
- Some hospitals only give privileges to their own employees (University hospitals, for instance)
Additional barriers to resuming obstetrical care:
- Many have lost the skills after a prolonged absence from OB, could need to be proctored back, refresher courses, ALSO and NRP training, etc.
- Malpractice insurance may go up high enough it wouldn’t offset money made from doing OB, depending on circumstances such as OB numbers, state of practice and OB malpractice rates, etc.
As with many ways of increasing the scope of practice, using social media and the DPCA membership to identify a mentor with experience is invaluable in achieving these goals.