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Family Medicine Guidelines Related to Utilization of Hospitalists
The following points may serve as guidelines for programs that operate within a system that utilizes hospitalists for inpatient care. These were developed by the RRC with reference to the Program Requirements for Residency Education in Family Medicine. In particular, they relate to the requirements regarding the provision of continuity of care and to faculty role-modeling.
- The family medicine model of care requires continuity of care for a population of patients seeking this model of care. This model requires the family physician to actively participate and manage the care of such patients regardless of the location/site of that care.
- Continuity requires the family physician to care for patients in the home, office setting, nursing home, emergency room and the inpatient facility.
- Residents must observe and participate in this model of care with the faculty as an integral and ongoing part of their training.
- Residents must be supervised by qualified family physicians in all of these settings to learn this model of care.
- Residents must be trained in settings where the family medicine faculty medicine and exemplify this model of care.
- Family Medicine faculty must have hospital privileges in the primary teaching institution and each program must have some who actively use these privileges in the care of hospitalized patients.
- The care of acutely ill patients in hospital settings will increasingly require an interdisciplinary care model. When such care is required, the family physician must participate in and coordinate the team.
- When hospitalists are used to cover inpatient services, the FM residency must play a part in the development of the arrangement and must ensure compliance with the Program Requirements. The hospitalists who participate in the supervision of the FM residents must be formally informed of the program's goals and objectives for the rotations involved and must participate in the evaluation of the residents in accordance with the program's procedures.
Program directors will be expected to demonstrate compliance with these guidelines if hospitalists are utilized on the inpatient services on which residents rotate.
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