When a doctor has “admitting privileges,” it is a formal authorization granted by a specific hospital allowing that physician to admit patients directly to that facility and oversee their care while they are hospitalized. This traditional model, where a primary care doctor follows their patient into the hospital, has largely been replaced in modern healthcare. Many doctors, particularly those focused on outpatient medicine, no longer hold these privileges, and this is a common organizational development rather than a sign of a doctor’s reduced competence. The shift away from this system is driven by changes in how hospitals deliver care, which means a patient’s routine care can be managed by another team without disruption.
Understanding Admitting Privileges
Admitting privileges are the formal rights granted by a hospital’s medical staff committee that permit a doctor to practice medicine within that facility. The hospital grants these privileges based on a doctor’s credentials, training, and performance history. A doctor might not pursue these privileges due to the high administrative burden of the application and renewal process, which involves extensive documentation and review.
The financial and time commitment required to maintain hospital credentials can be substantial, especially for physicians specializing entirely in office-based care. Many physicians choose not to dedicate time to hospital-based responsibilities because their practice is strictly limited to the outpatient setting.
The widespread adoption of the hospitalist model has made admitting privileges less relevant for many primary care physicians (PCPs). The utility of maintaining privileges has diminished significantly since PCPs would rarely be available to perform daily rounds alongside their rigorous office schedule. Consequently, lacking privileges reflects their practice focus within the current healthcare landscape, not their medical expertise.
Who Manages Your Care While Hospitalized
If you require admission and your regular doctor does not have admitting privileges, your care is transferred to a physician known as a Hospitalist. Hospitalists specialize exclusively in the care of hospitalized patients, managing all aspects of treatment from admission until discharge. This specialization allows them to be physically present in the hospital at all times, leading to quicker decision-making and immediate responses to changes in a patient’s condition.
The Hospitalist functions as your primary doctor during your stay, coordinating with nurses, ordering necessary tests, and prescribing medications. They are highly experienced in the common acute illnesses that require hospitalization. This dedicated focus on inpatient medicine means they are deeply familiar with hospital protocols and resources, enhancing the efficiency of your care.
The Hospitalist team works in close collaboration with any specialists, ensuring all medical treatments are aligned under one central manager. The Hospitalist is readily available throughout the day, resulting in a more streamlined and responsive care experience. This 24/7 in-house coverage allows your PCP to concentrate fully on their outpatient practice.
Maintaining Continuity of Care After Discharge
The primary challenge created by the transfer of care to a Hospitalist is ensuring a seamless handoff back to the outpatient setting after discharge. Continuity of care depends heavily on the effective transmission of all hospitalization details to your regular doctor. The discharge summary is the document that bridges this gap, containing the patient’s diagnosis, treatment plan, and any changes to their medication regimen.
Communication breakdowns can occur in this transfer of information, which can compromise patient safety. Studies indicate that many primary care physicians do not receive the official discharge summary before the patient’s first follow-up appointment. This delay or lack of information can lead to confusion, especially regarding medication reconciliation, where a patient may be taking conflicting prescriptions from the hospital and their home doctor.
A key risk is that critical results from tests conducted just before discharge may not be fully reviewed or acted upon by the outpatient doctor if they are not specifically flagged and sent. These results typically go to the Hospitalist, who is no longer actively managing the patient’s care. To mitigate this, hospitals must have established arrangements with non-hospital providers that clearly outline procedures for discharge planning and tracking of outstanding results.
Patient Action Steps
The first practical step is to know your doctor’s status by asking them directly if they hold admitting privileges at your local hospitals. If they do not, inquire about the formal arrangements they have with the hospitalist group or a specific facility to coordinate your admission. Knowing this information beforehand can alleviate stress during an unexpected health crisis.
If you are admitted to the hospital, ensure the Hospitalist team receives the current contact information for your primary care physician. You must also authorize the hospital to share your medical information, as required by privacy regulations, to enable clear communication between the two doctor teams. During the discharge planning meeting, confirm that a comprehensive discharge summary is being electronically sent to your regular doctor immediately.
Before leaving the hospital, verify your medication list with the Hospitalist, making sure you understand which home medications were stopped and what new prescriptions were added. Schedule a follow-up appointment with your regular doctor within one week of discharge. Bring any printed discharge instructions with you to ensure they can review the details of your hospital stay.