Abstract
OBJECTIVE: To investigate whether hospital activities and attitudes toward hospitals of members of an urban family medicine department changed between 1977 and 1997. To explore whether these activities and attitudes are different among fee-for-service (FFS) and non-FFS physicians in 1997. DESIGN: Cross-sectional surveys by interview (1977) and self-administered questionnaire (1997). SETTING: Community-based family practices in Hamilton, Ont. PARTICIPANTS: In 1977, 88 of 89 (98.9%) and, in 1997, 66 of 88 (75.0%) members of the Department of Family Medicine at St Joseph's Hospital in Hamilton. MAIN OUTCOME MEASURES: Perceived reasons for involvement in hospital work; time spent and main activities in hospital; use of hospital privileges; attitudes toward family physicians' role in hospital, hospital work, and the Department of Family Medicine; perceptions of patients', consultants', and hospital administrators' attitudes toward family physicians' role in hospitals. RESULTS: In 1977 and 1997, patient care and continuing education remained key reasons for doing hospital work. In 1997, however, respondents spent a mean of 3 hours less per week in hospital; used the hospital less often for procedures, meetings, and teaching; and assumed less responsibility for their patients' in-hospital care. While perceptions of hospital work changed over the years, most physicians continued to see a need and have a desire to remain involved in hospitals. Fee-for-service and non-FFS physicians held different opinions on the needs of both hospitalized patients and family physicians. CONCLUSION: Although physicians' hospital activities and attitudes changed between 1997 and 1997, most continued to see a need and have a desire to remain involved in hospitals.
Full Text
The Full Text of this article is available as a PDF (69.7 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bass M. J., McWhinney I. R., Stewart M., Grindrod A. Changing face of family practice. Can Fam Physician. 1998 Oct;44:2143–2149. [PMC free article] [PubMed] [Google Scholar]
- Clinton C., Schmittling G., Stern T. L., Black R. R. Hospital privileges for family physicians: a national study of office based members of the American Academy of Family physicians. J Fam Pract. 1981 Sep;13(3):361–371. [PubMed] [Google Scholar]
- Evans E. O., McEwan E. D. Future role of the general practitioner in the hospital service. Br Med J. 1969 Jan 18;1(5637):172–173. doi: 10.1136/bmj.1.5637.172. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Harris M. F., Fisher R. R., Knowlden S. M. Improving general practitioner involvement in urban hospitals. Departments or divisions of general practice. Med J Aust. 1993 Mar 1;158(5):304–307. doi: 10.5694/j.1326-5377.1993.tb121782.x. [DOI] [PubMed] [Google Scholar]
- Henry L. A. Working with hospitalists. Fam Pract Manag. 1997 Nov-Dec;4(10):32-4, 37-42. [PubMed] [Google Scholar]
- Hutchison B., Birch S., Hurley J., Lomas J., Stratford-Devai F. Do physician-payment mechanisms affect hospital utilization? A study of Health Service Organizations in Ontario. CMAJ. 1996 Mar 1;154(5):653–661. [PMC free article] [PubMed] [Google Scholar]
- Hutchison B., Woodward C. A., Norman G. R., Abelson J., Brown J. A. Provision of preventive care to unannounced standardized patients. CMAJ. 1998 Jan 27;158(2):185–193. [PMC free article] [PubMed] [Google Scholar]
- Jones R. General practitioners and hospitals. J R Coll Gen Pract. 1986 Aug;36(289):346–347. [PMC free article] [PubMed] [Google Scholar]
- Kaczorowski J., Levitt C. Intrapartum care by general practitioners and family physicians. Provincial trends from 1984-1985 to 1994-1995. Can Fam Physician. 2000 Mar;46:587-92, 595-7. [PMC free article] [PubMed] [Google Scholar]
- Lemire F. Role of the family doctor in hospital. Can Fam Physician. 1998 Nov;44:2369–2371. [PMC free article] [PubMed] [Google Scholar]
- Levitt C. Addressing a crisis. Can Fam Physician. 1999 Mar;45:553-5, 562-4. [PMC free article] [PubMed] [Google Scholar]
- Lowy A., Brazier J., Fall M., Thomas K., Jones N., Williams B. T. Minor surgery by general practitioners under the 1990 contract: effects on hospital workload. BMJ. 1993 Aug 14;307(6901):413–417. doi: 10.1136/bmj.307.6901.413. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Montalto M., Gunesekera A., Sanderson F. The use of inpatient admission privileges by members of a division of general practice. Aust Fam Physician. 1994 Mar;23(3):453-7, 460-1. [PubMed] [Google Scholar]
- O'Cathain A., Brazier J. E., Milner P. C., Fall M. Cost effectiveness of minor surgery in general practice: a prospective comparison with hospital practice. Br J Gen Pract. 1992 Jan;42(354):13–17. [PMC free article] [PubMed] [Google Scholar]
- Reid A. J., Grava-Gubins I., Carroll J. C. Family physicians in maternity care. Still in the game? Report from the CFPC's Janus Project. Can Fam Physician. 2000 Mar;46:601-6, 609-11. [PMC free article] [PubMed] [Google Scholar]
- Rochon P. A., Gurwitz J. H. Prescribing for seniors: neither too much nor too little. JAMA. 1999 Jul 14;282(2):113–115. doi: 10.1001/jama.282.2.113. [DOI] [PubMed] [Google Scholar]
- Schattner P., Dunt D. General practitioner involvement in non-procedural medicine in public hospitals in Melbourne, Australia. Fam Pract. 1989 Jun;6(2):141–145. doi: 10.1093/fampra/6.2.141. [DOI] [PubMed] [Google Scholar]
- Sicotte C., Beaudoin C., Jacques A., Millette B. Family physicians' involvement in two hospitals. Two different models of inpatient care. Can Fam Physician. 1996 Oct;42:1939–1944. [PMC free article] [PubMed] [Google Scholar]
- Stadler D. S., Zyzanski S. J., Stange K. C., Langa D. M. Family physicians and current inpatient practice. J Am Board Fam Pract. 1997 Sep-Oct;10(5):357–362. [PubMed] [Google Scholar]
- Woodward C. A., Rosser W. Effect of medicolegal liability on patterns of general and family practice in Canada. CMAJ. 1989 Aug 15;141(4):291–299. [PMC free article] [PubMed] [Google Scholar]