Why Patients Would Want a Primary Doctor who
Goes to the Hospital to be the
Attending Dr. in Charge of his/her Patients

I think patients would want to see a primary doctor who, when his or her patients need to go into the hospital, he will go there not just to say "hi" then leave the patient's overall care and specialist coordination to the hospital's hospitalist doctors, but will be the attending doctor in overall charge.

Three Advantages

Why is that important? Because it gives the patients three advantages that are not available with other primary care doctors:

  1. The patient gets personalized care when he/she needs it the most, when he/she is sick enough to go into the hospital. His/her personal doctor knows him/her, can customize his/her care, and also, can get the specialists to customize the care.

  2. Such primary doctors have medical knowledge that is a class above. They see at first hand what serious disease looks like, what complications look like, what possible short- and long-term problems can arise after discharge and how they are related to the hospitalization and the treatment rendered there, and so forth. They also treat serious disease and all the coomplications, along with nurses, specialists and other providers, at first hand. With such intimate knowledge of serious disease these doctors are better able to nip things in the bud -- they can more quickly recognize the early signs and they know in more depth what to do. And since they know both office and hospital medicine, they are better at keeping a patient's existing conditions, maybe mild now, from developing into serious disease later.

  3. To be able to do both office medicine and hospital medicine, such primary care doctors have to constantly read, study and go to seminars to stay up to date.

Part of All-around, Personalized, Continuous, Coordinated (APCC) Care

The PCP going to the hospital is what makes that PCP an APCC Care doctor. The personalized, whole person clinical reasoning and treatment logic that the APCC Care doctor constantly updates and refines is carried into the hospital care setting by the PCP and continued. Especially for complex patients, this continuity in clinical reasoning and treatment logic makes a big difference in outcome. There is much less chance of some part of the patient's overall condition, some nuance, getting overlooked. Also, during the hospitalization the attending PCP himself/herself plays a key part in formulating the updated clinical reasoning and treatment logic and thus after discharge can continue on with every nuance. More consistent, more finely tuned outpatient care then results in fewer decompensations and hospitalizations going forward.

I credit my going to the hospital for a big part of my patients' much reduced hospitalization rate.