The hospital role of family physicians.

This paper examines the hospital role of a random sample of all general and family physicians in the state of Washington. Of the 287 physicians in our sample, 81% admitted at least one patient to hospital during the two-week study period, and the average physician admitted six patients. The majority of the admitting diagnoses fell within the realm of internal medicine. Residency-trained and board-certified respondents were more likely to admit patients to hospital, and residency-trained and rural practitioners were much less likely to refer patients to other physicians for hospital care than their urban counterparts. Residency-trained physicians, in particular, were much more likely to practice hospital obstetrics than those without formal residency training. These data demonstrate the broad and significant hospital role of the family physician. Given the increased scope and intensity of hospital practice of residency-trained family physicians, and barring major changes in admitting privileges or new regulatory constraints, we predict that this group of physicians will continue to have a significant inpatient role in the United States.