Title

The erosion of the primary care doctor-patient relationship during hospitalization.

Date of Award

5-1-2014

Document Type

Thesis

School

Caspersen School of Graduate Studies

Degree Name

Master of Medical Humanities

Abstract

The role of the primary-care physician during hospitalization has undergone a major shift in the last fifteen years. Amid economic pressures, lifestyle choices and the increasing specialization of medicine, primary-care physicians and hospitals now contract with groups of inpatient physicians known as hospitalists, to care for their patients when an inpatient stay is necessary. In so doing, primary-care physicians give up their privileges of seeing their patients while in the hospital, confining their practice to the outpatient setting, while the hospitalist manages the care of their patients exclusively in the inpatient setting. With this changing landscape, more often than not patients no longer see their primary care doctors while hospitalized for illness or injury. This thesis looks at the relatively new model of hospitalist care in the United States, common forces that helped it to emerge and the effects it has had on the doctor-patient relationship. I argue that the hospitalist model of care compromises the continuity of care by breaking established doctor-patient relationships when patients are admitted to the hospital, a time at which they are most vulnerable.