Health Team

Hospitalized patients may not see their primary care doctors

Posted April 21, 2009 5:40 p.m. EDT
Updated April 21, 2009 6:36 p.m. EDT

Last year, Betty Moore was hospitalized with pneumonia. She said seeing her primary care physician eased her anxiety.

“When I saw Dr. Sharma in the door, I smiled and said, ‘I am so glad to see you’re here,’” Moore said.

Moore and Dr. Gulshan Sharma, of the University of Texas’ medical branch, have relationship continuity – something considered to be at the core of quality health care.

“It fosters trust between patient and physician. It improves communication,” Sharma said.

Hospitalized patients seeing a primary care doctor may not be very common, according to a study published in the Journal of the American Medical Association.

Researchers found, in a sample of Medicare claims, the number of patients who saw their regular doctor while hospitalized dropped more than 12 percent over 10 years.

Medicare allows reimbursement for only one general physician during a hospital visit.

“So it is a financial disincentive for a primary care physician to see a patient while a patient is already receiving care by a hospital physician,” Sharma said.

Distance to the hospital may also keep some primary care doctors from visiting.

The study did not find relationship continuity to be higher for older patients with other health issues like Moore.

“I think that it's very important to have a doctor that understands your age and your medical problems,” Moore said.

Even when researchers broadened the definition of continuity of care – to include any doctors who'd seen a patient in an outpatient setting in the past year, there was still a decline of more than 10 percent in the same 10 year period.