Role of family physicians in hospitals. Did it change between 1977 and 1997?
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OBJECTIVE: To investigate whether hospital activities and attitudes toward hospitals of members of an urban family medicine department changed between 1977 and 1997. To explore whether these activities and attitudes are different among fee-for-service (FFS) and non-FFS physicians in 1997. DESIGN: Cross-sectional surveys by interview (1977) and self-administered questionnaire (1997). SETTING: Community-based family practices in Hamilton, Ont. PARTICIPANTS: In 1977, 88 of 89 (98.9%) and, in 1997, 66 of 88 (75.0%) members of the Department of Family Medicine at St Joseph's Hospital in Hamilton. MAIN OUTCOME MEASURES: Perceived reasons for involvement in hospital work; time spent and main activities in hospital; use of hospital privileges; attitudes toward family physicians' role in hospital, hospital work, and the Department of Family Medicine; perceptions of patients', consultants', and hospital administrators' attitudes toward family physicians' role in hospitals. RESULTS: In 1977 and 1997, patient care and continuing education remained key reasons for doing hospital work. In 1997, however, respondents spent a mean of 3 hours less per week in hospital; used the hospital less often for procedures, meetings, and teaching; and assumed less responsibility for their patients' in-hospital care. While perceptions of hospital work changed over the years, most physicians continued to see a need and have a desire to remain involved in hospitals. Fee-for-service and non-FFS physicians held different opinions on the needs of both hospitalized patients and family physicians. CONCLUSION: Although physicians' hospital activities and attitudes changed between 1997 and 1997, most continued to see a need and have a desire to remain involved in hospitals.
