Family physicians and current inpatient practice.

BACKGROUND Increasing demand for primary care physicians has led some to recommend that family physicians focus on ambulatory care, leaving inpatient care to hospital-based physicians only. This study examines the current level of family physician involvement in the care of hospitalized patients and the factors which determine that involvement. METHODS A questionnaire was sent to a random sample of 415 practicing family physician members of the American Academy of Family Physicians. An inpatient involvement score was generated based on responses to a series of hypothetical clinical scenarios involving hospitalized patients. Physician and practice characteristics were tested for associations with the involvement score. RESULTS The typical responding physician (n = 228) was male, married, and board certified, with an average age of 45 years and in community-based practice. The median number of annual admissions was 60. Independent predictors of inpatient involvement were younger physician age, greater enjoyment of inpatient and outpatient medicine, fewer extrahospital obligations, and less-complex disease in the hospitalized patient. CONCLUSIONS Inpatient medicine continues to figure prominently in the work of family physicians. The strongest predictors for inpatient involvement are those controlled by the physician's individual choices and characteristics rather than external and bureaucratic factors.