Patients: Hospital Privileges Don't Mean Overruling Care Decisions


Getting patients to understand hospital privileges - and what I can do for them when admitted - is often a difficult discussion.

When my patients are admitted to the hospital I am affiliated with, I am often asked to see them while they are there. If they are admitted elsewhere, I can’t. Patients often don’t understand that.

I had one patient call me from his hospital room asking me to change his insulin doses because, "They are doing it all wrong." I said that I could not, and that I probably should not. I did not know all the circumstances of his admission, what the plans were for his stay, etc. I did say that I would gladly speak to the physician taking care of him if that would be helpful. Unfortunately, he couldn’t tell me who to speak to. It told him to have his admitting physician call me. He never did. The next time the patient came to the office, he told me he was angry with me because I didn’t see him when he was in the hospital. I again told him that I did not have privileges at that hospital and that even if I paid him a "social visit," I would not have been able to write any orders.

Another patient called last week and spoke to my associate. She was admitted to a hospital a couple of towns east of us and wanted us to call in her insulin orders "because they don’t know what they’re doing." A description of what "they" were doing sounded appropriate for her reason for admission, and the best my associate could offer was to speak to the endocrinologist at that hospital.

While it is both heartening and humbling to have some of our patients believe that we are the only ones capable of caring for them, the reality is that there are physicians who are fully able to treat them when they are admitted to the hospital. Physician-to-physician communication about the patient is always helpful when transitioning in and out of the hospital, and that should help alleviate some of the fear.

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