Lack of Access to and Control of Patients a Major Problem for Private-Practice Physicians

By Jeremy Brooker

Often, when people find themselves in a situation where they’ve gone to the hospital for an emergency or other after-hours issue – their family doctor or personal physician may not legally be able to service them there, and communication about their conditions from hospital staff to their physician may be poor or non-existent. 

For physicians that care about their clients and know their personal medical history (which can play a valuable role in healthcare-related decisions), this is cause for concern. 

“Most primary care physicians are experiencing a shrinking role in hospital care,” said Michael Demoratz, palliative care expert, PhD and LCSW, “and that’s not necessarily a good thing.” 

Lack of communication about condition and status becomes even more of an issue with aging patients, given that they typically see an increase in the frequency of hospital visits and medical care due to issues like Alzheimer’s, dementia, broken bones, congestive heart failure, and the slew of other health related problems that come with age.

“It gets interesting when you have three or more sources that have provided, or sometimes continue to provide, an individual with care,” said Michael. “Communication breaks down, and so does a clear plan of care and control.” 

When asked what can be done by primary care physicians to improve their own access to and control of patients, Michael was reticent.  

“It can be very hard,” he noted.

“If [patients] go to a hospital on their own, the physician may lose control. If you’re a physician who is sending a patient to the hospital, you can prevent that sort of thing by sending them to a medical facility with hospitalists that you know and that will communicate with you, or to one that allows you to follow and access them yourself,” he said. 

According to Michael, physicians tend to maintain access to and control of their patients by having this kind of presence in skilled nursing facilities, nursing homes, and hospitals. 

“Another great option, especially in certain situations – is in-home senior care.”

Michael explained how having a caregiver in a patient’s home can keep physicians up to date on the status and whereabouts of a patient.

“Caregivers, especially from some of the better companies, know what warning signs to look for when a senior has an issue, and they know how to care for a person who has a condition or history with a certain issue.”

Since in-home caregivers assist with things called “activities of daily living,” (which include things like bathing, dressing, eating, functional mobility and toilet hygiene), they can act as “boots on the ground” for physicians, and can monitor their patients’ statuses from day to day. 

Many senior care companies have software that provides real-time, up-to-date information on patients’ statuses, and some even have devices that monitor patients’ vital signs and log the reports in real-time.“This kind of thing is invaluable for physicians, especially in certain cases,” Demoratz said. 

According to Michael, measures like these are important not only to keep physicians in touch with their patients - they also play an integral part in reducing the problem of hospital readmissions.