She was up to the floor to check someone in rapid A-fib, and was finishing up her physician’s notes, talking about …what was it? Vacationing in the Caribbean. Two nurses had just returned with tans to die for. So I posed the question.
”How are admitting privileges established with any given hospital?” The question seemed to suprise her. She tried to answer what she thought I was asking, but I had to keep asking questions to steer in the direction I was seeking. “When physicians are licensed in the state, how come they can only practice at certain hospitals?” Her answers were all over the place. Finally I told her about my father’s experience with his stroke. And I said that I thought admitting privileges might cause more medical errors and prolonged stays than about any other issue in hospitalization. SHE AGREED WITH ME.
Among the issues discussed:
- Doctors don’t want to be pulled every which way and like to limit their practice to one geographical area.
-Hospitals use admitting privileges as a way to staff certain needs. For example, to gain admitting privileges to one hospital, you might need to have done X number of cardioversions, and have to give that hospital documentation that you’ve done so, along with other skills. This way they know when you’re overseeing residents, you can run a code properly. To have admitting privileges, you have to serve X amount of time overseeing residents. If you are a cardiologist, you may have to read EKG’s at set intervals. So for a doctor, establishing admitting priviledges at more than one hospital may require extensive paperwork and time commitments.
Okay, I can see the purpose in the hospital functioning, and to a degree in patient care. But if the way something is set up causes more errors and more expense in any given illness than other issues, shouldn’t its efficacy be questioned and looked at? I think so.
