The physician exodus from hospitals. 1997

P C Royce
Segal Company, New York, USA.

Physicians are spending increasingly less of their work week in the hospital. This is true of surgeons because they are performing more ambulatory surgery, often off the hospital premises, and for primary care physicians because they are delegating hospital care of their patients to others. What are the effects of this physician exodus on hospitals, patients, physicians, and medical education? Some of these consequences are explored, from disruptions in the continuity of care, to increase in practice productivity, to preparing undergraduates for the realities of medical practice.

UI MeSH Term Description Entries
D007325 Institutional Practice Professional practice as an employee or contractee of a health care institution. Institutional Practices,Practice, Institutional,Practices, Institutional
D008329 Managed Care Programs Health insurance plans intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as HEALTH MAINTENANCE ORGANIZATIONS and PREFERRED PROVIDER ORGANIZATIONS. Case Management, Insurance,Insurance Case Management,Managed Health Care Insurance Plans,Managed Care,Care, Managed,Managed Care Program,Management, Insurance Case,Program, Managed Care,Programs, Managed Care
D008486 Physician Executives Physicians who serve in a medical and administrative capacity as head of an organized medical staff and who also may serve as liaison for the medical staff with the administration and governing board. Medical Directors,Director, Medical,Directors, Medical,Medical Director,Executive, Physician,Executives, Physician,Physician Executive
D008505 Medical Staff, Hospital Professional medical personnel approved to provide care to patients in a hospital. Attending Physicians, Hospital,Hospital Medical Staff,Physicians, Junior,Registrars, Hospital,Attending Physician, Hospital,Hospital Attending Physician,Hospital Attending Physicians,Hospital Medical Staffs,Medical Staffs, Hospital,Hospital Registrar,Hospital Registrars,Junior Physician,Junior Physicians,Physician, Junior,Registrar, Hospital,Staff, Hospital Medical,Staffs, Hospital Medical
D010819 Physician's Role The expected function of a member of the medical profession. Physicians' Role,Physician Role,Physician's Roles,Physicians Role,Physicians' Roles,Role, Physician's,Role, Physicians',Roles, Physician's,Roles, Physicians'
D003266 Continuity of Patient Care Health care provided on a continuing basis from the initial contact, following the patient through all phases of medical care. Continuum of Care,Continuity of Care,Care Continuity,Care Continuity, Patient,Care Continuum,Patient Care Continuity
D004504 Education, Medical, Undergraduate The period of medical education in a medical school. In the United States it follows the baccalaureate degree and precedes the granting of the M.D. Medical Education, Undergraduate,Education, Undergraduate Medical,Undergraduate Medical Education
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000078329 Workforce The number of people working or available for work or service. Human Resources,Labor Supply,Manpower,Staffing,Womanpower,Human Resource,Labor Supplies,Manpowers,Staffings,Supply, Labor,Womanpowers,Workforces
D000556 Ambulatory Surgical Procedures Surgery performed on an outpatient basis. It may be hospital-based or performed in an office or surgicenter. Ambulatory Surgery,Day Surgery,Office Surgery,Outpatient Surgery,Surgery, Office,Surgery, Outpatient,Ambulatory Surgical Procedure,Procedure, Ambulatory Surgical,Procedures, Ambulatory Surgical,Surgery, Ambulatory,Surgery, Day,Surgical Procedure, Ambulatory,Surgical Procedures, Ambulatory,Ambulatory Surgeries,Day Surgeries,Office Surgeries,Outpatient Surgeries,Surgeries, Ambulatory,Surgeries, Day,Surgeries, Office,Surgeries, Outpatient

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