Admitting Privileges

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rich126
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Joined: Thu Mar 01, 2018 3:56 pm

Admitting Privileges

Post by rich126 »

I don't think this is medical advice but if so, sorry.

Does it matter if a specialist has admitting privileges at hospitals?

Ideally is that something you want?
----------------------------- | If you think something is important and it doesn't involve the health of someone, think again. Life goes too fast, enjoy it and be nice.
lj3md
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Re: Admitting Privileges

Post by lj3md »

I have admitting privileges. If patients have multiple medical conditions, then I will have a Hospitalist admit the patient and I will consult.

At our hospital, some services do not admit, such as GI and I think cardiology. They still see the patient and take care of the specific problem related to their specialty.

The key thing is to make sure they have privileges at a hospital that you feel comfortable going to. We have some people in our town who do everything at a surgery center, but then just send the patient to our ER when there is a problem for us to take care of.
lj3md
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Re: Admitting Privileges

Post by lj3md »

Just a clarification, they should have either admitting or consulting privileges at a hospital you are comfortable with.
henry
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Re: Admitting Privileges

Post by henry »

rich126 wrote: Tue Apr 02, 2024 8:57 pm I don't think this is medical advice but if so, sorry.

Does it matter if a specialist has admitting privileges at hospitals?

Ideally is that something you want?
If you want the said specialist or his/her group to manage your problem and provide continuity of care should you be admitted, then it probably matters. But if not, then it doesn't matter.

Now that also begs the question of what specialty you are referencing and what is the particular problem or issue being managed. Many problems can be adequately or even completely be managed as an outpatient while other problems cannot.

It would not be appropriate to say more given the rules of this forum as I think it would stray into medical advice.
Rex66
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Re: Admitting Privileges

Post by Rex66 »

Not if it’s strictly an outpatient service
syc
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Re: Admitting Privileges

Post by syc »

rich126 wrote: Tue Apr 02, 2024 8:57 pm I don't think this is medical advice but if so, sorry.

Does it matter if a specialist has admitting privileges at hospitals?

Ideally is that something you want?
I notice you said "hospitalS", plural. Are you asking whether it matters whether a physician can see you and help take care of you in a hospital you expect to be? Or are you asking whether having admitting privileges at some hospital(s), like at least one, is an indicator of skill, diligence, or some other desirable characteristic?
syc
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Re: Admitting Privileges

Post by syc »

lj3md wrote: Tue Apr 02, 2024 9:10 pm I have admitting privileges. If patients have multiple medical conditions, then I will have a Hospitalist admit the patient and I will consult.

At our hospital, some services do not admit, such as GI and I think cardiology. They still see the patient and take care of the specific problem related to their specialty.

The key thing is to make sure they have privileges at a hospital that you feel comfortable going to. We have some people in our town who do everything at a surgery center, but then just send the patient to our ER when there is a problem for us to take care of.
I would think that "admitting" versus "consulting" is a subtle, technical distinction that matters to the physician but not to the patient. Most patients are pragmatic about this; they just want to know, of the physician with whom they have a strong bond, "can you come and take care of me in the hospital?"
Topic Author
rich126
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Re: Admitting Privileges

Post by rich126 »

Thanks. Obviously this isn't the place to get into details and I don't have anything that requires hospitalization. I was looking at doctors and when I looked at my specialist I noticed he did not have any admitting privileges. I'll be seeing him late this month so I'll try to remember to ask that question and see what his response is to the question.

The doctor works at a fairly large group practice that is well regarded in the AZ area.

I recall a friend who said his doctor was able to admit him to the hospital which bypassed waiting to get in. Obviously I'm not a doctor and don't quite understand the process and thankfully I haven't been admitted to a hospital as an adult.

Thank you.
----------------------------- | If you think something is important and it doesn't involve the health of someone, think again. Life goes too fast, enjoy it and be nice.
brandy
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Re: Admitting Privileges

Post by brandy »

My PCP does not have admitting privileges to my preferred hospital.
So if my PCP decides that I should be admitted to a hospital, how do I get myself admitted to my preferred place?
I do have 3 specialists in that hospital system. However, they are all 45 minutes at 70MPH away. (the 3 hospitals are that distance, too. (When I first came here, we lived an easy 20 minutes from the hospital and emergency ward that I went into. I just stayed with them.)
My new-ish PCP is 15 minutes, 35-40MPH away. I do have the option of choosing one of my hospital system docs as PCP, but they're still so far away.

This system uses MyChart, and that's where 99% of my med history is, so history's not a problem.
henry
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Re: Admitting Privileges

Post by henry »

rich126 wrote: Wed Apr 03, 2024 8:58 am
I recall a friend who said his doctor was able to admit him to the hospital which bypassed waiting to get in. Obviously I'm not a doctor and don't quite understand the process and thankfully I haven't been admitted to a hospital as an adult.
Say this specialist doesn't have admitting privileges. If you need an elective procedure related to their specialty and this specialty group does their procedures at the hospital, he can have one of his colleagues who has hospital privileges perform your procedure on a scheduled basis at the hospital.

If you see him in the office and he feels you need to be admitted to the hospital, he can ask one of his colleagues who has admitting privileges to admit you to the hospital and it might save you from having to go through the emergency department. Many large groups have someone "on-call" covering the hospital.

However, in practice, many specialists will only admit patients to the hospital under their service under limited circumstances. Often it's difficult to tell if the problem you have which requires hospitalization is primarily related to their specialty. Most patients have more than one medical problem that requires management; often many other concurrent problems that are outside the realm of said specialist.

Consequeuntly, the specialist may just send you to the ER so you can get initially evaluated and tested and potentially diagnosed. Similarly, if you call the specialist's office over the phone, they may feel you need to evaluated by the symptoms you describe, but it can be difficult to determine how stable you are or how emergent your case is over the phone, and if the problem you are experiencing is related to their specialty. For safety's sake, they may instruct you to go the ER or call 911 to bring you to the ER so that you can be evaluated.

At the ER, the ER provider sees you and then decides if you need to be admitted, and if so, decides who to call to admit you. He may call the specialist directly to see you if he feels this is an emergent problem related to the specialist's specialty that requires his expertise now. If there isn't something the specialist needs to see you emergenty for and if the ER provider still feels you need to be admitted, then he calls the hospitalist to admit you and care for you and direct your care. Depending on the problem, the hospitalist may involve your specialist or other specialists if needed.

If your primary care provider still admits patients, then the ER provider will call your PCP or whomever is on call for him to will admit you and direct your care. But that is more rare these days as most PCPs are 100% office and most PCPs use hospitalists, but there are still some primary care groups that admit their patients.
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lthenderson
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Re: Admitting Privileges

Post by lthenderson »

rich126 wrote: Wed Apr 03, 2024 8:58 am I was looking at doctors and when I looked at my specialist I noticed he did not have any admitting privileges.
I would not be worried. Most likely, if they need to admit you, they know who to call to get you admitted. My spouse runs a clinic and none of her staff has admitting privileges to the hospital. But they know who to call should you need to be admitted.
fasteddie911
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Re: Admitting Privileges

Post by fasteddie911 »

Probably not a big deal.
Tattarrattat
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Re: Admitting Privileges

Post by Tattarrattat »

The modern model is your outpatient MD only sees you as an outpatient and if you get hospitalized, you get managed by a hospitalist team, a dedicated hospital based team of practitioners - MD/DO/PA/NP - whose whole job is to mange you during your admission. Many MDs have given up doing both outpatient and inpatient medicine and many hospital systems prefer it that way.
syc
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Re: Admitting Privileges

Post by syc »

Tattarrattat wrote: Wed Apr 03, 2024 7:54 pm The modern model is your outpatient MD only sees you as an outpatient and if you get hospitalized, you get managed by a hospitalist team, a dedicated hospital based team of practitioners - MD/DO/PA/NP - whose whole job is to mange you during your admission. Many MDs have given up doing both outpatient and inpatient medicine and many hospital systems prefer it that way.
This is, sadly, often true. But it's not universal. Several family medicine groups in our area still follow their own inpatients. Hospital systems make many claims for improved efficiency and quality with this new model, but there are many glaring mishaps in the "handoffs" from hospital to home. I do see the point with physicians whose offices are out in the country, with long travel times to hospital.
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