As a current PGY III Resident Physician, I am currently searching for employment. I am currently completing a Family Medicine residency with a Hospitalist "track". The evidence of discrimination is in plain sight. Hospitals are shameless in their recruitment advertisements, stating "No FPs", or "BE/BC IM only". I have found it intensely difficult to secure interviews. I did look into practicing in California, but have decided to abandon the state. I am presently looking into positions in Oregon and Washington, however my search is yeilding similar discriminatory practices. We need advocacy on this issue, but have none. Family Medicine trained doctors have something very unique to offer the field of Hospitalist Medicine - it goes unrealized however. The problem is, Family Practitioners have been made to feel as though they are the "red headed step child" in medicine. Because of this, we feel unworthy and are reluctant to stand up for ourselves. Either we can continue to let OB-GYN, Pediatrics, Internal Medicine, et al stomp us into the ground further, or we can rise up and say enough is enough! The field of medicine was created on the backs of Family Physicians - we have lost our identity however. Our governement says they need more of us, but recruiters and hospitals tell us to stay away. Something must be done but I have little faith in my lifetime anything will happen.

I continue to raise the issues regarding FP/Hospitalists and the ignorance with which the interest of this group of family physicians is treated by the almighty leaders of CAFP. It is astonishing that in the CAFP websites you will see attention to the favorite ice cream flavor of m ember of the month Dr. Michael Schrager (with all due respect to Dr Schrager, I share your love for vanilla ice cream as well), but you do not see any attention to the discriminatory practices in hiring Family Physicians as Hospitalist? Is it possible the almighty leaders of CAFP are out of touch? Or do they not care. CAFP as an organization that presumably protects the interest of Family Physicians can be very helpful. Why do we not have a chapter for FP/hospitalists? why mostly in California Family Physicians are discriminated against? A concerted campaign in California by educating the employers and hospitals would eliminate the hurdles against Family Physicians who choose to be Hospitalist. I invite everyone just to call potential employers( Not all but a large majority) listed in www.career MD.com ( Call Kaiser Narlyn Villaruel Sr. Physician Recruiter at 800-777-4912 , or sutter medical group Kristine walter 800-650-0625 or WalterKL@sutterhealth.org) and see for yourelf how Family Medical Doctors are excluded from being considered as Hospitalist just because they are Family Physicians and not Internist. I believe Family Physicians have everything they need to have to be Hospitalist, and there should be no but, if or otherwise in hiring any Family Physicians as Hospitalists because of our specialty.

When I raised my concerns regarding discriminatory practices in hiring Family physicians as Hospitalist, again I receive couple of cosmetic letters without actions. All you have to do is just look at some of the Adds in www.careermd.com and you shall see, contact some of these potential employers and talk to them if they hire Family physicians as Hospitalist? For example contact Kaiser a major employer in Northern and southern California, which does not hire family Physicians as hospitalist, only when you are hired for outpatient then you would be utilized just to cover the short comings. Please take a look at their add in careermd.com and you will see this-->"We are currently recruiting full-time Internal Medicine Physicians for our Hospitalist opportunities in Modesto, Fresno, South Sacramento and Vacaville locations. We are also hiring full time nocturnist This is despite the fact the recently there has been an agreement between Boards of Family Medicine and Internal Medicine regarding a new track that will lead to board certification in Hospital Medicine. Please if you in the Academy want to do something (I certainly hope you do), is to contact all employers such as Kaiser and educate them so this will not be a rule to exclude Family Physicians. We do not expect CAFP or AAFP to dictate to hospitals, but calls and letters on behalf of Family Physicians will bring change. The reason why some Hospitals exclude Family Physicians as hospitalist is because in Agreement letters the word family Medicine is missing instead Internal Medicine is. Also I found lack of information about abilities of Family Physicians, as some of the hospital administrators believe Family Physicians are only trained to work as outpatient. This is mostly in California, Other parts of the country is not like California. That’s why the almighty leaders of CAFP can do some good. I believe a concerted effort on behalf of Family Physicians would eliminate discriminatory Practices in California who choose to be Hospitalist. Family Physicians expectCAFP who claim is acting on behalf of Family Physicians to do more than just washing their hands.

Hossein, Your concerns about Hospitalist speaks to the importance of Family Physicians being involved with the governance of the hospital medical staff. It is vital that we are involved at all levels, from department chairs, quality council, Medical Executive Committee and Board. It is only through local involvement from Family Physicians that necessary changes occur. The CAFP or AAFP can't dictate what happens in every hospital. The Joint Commission will usually support the recommedations from an local organized medical staff. Please contact me if I can help.

Dr. Ebneshahidi:

The Academy has adopted several policies related to hospitalists. I've listed the two most relevant at the end of this post. In addition, AAFP has prepared a template letter which states that allowing only internists to serve as hospitalists directly contradicts AAFP and the Society of Hospital Medicine policy on the issue. Here is a link to the letter: http://www.aafp.org/online/en/home/practicemgt/specialtopics/hospitalists/fpsashospitalists.html.

We would encourage you to submit this letter. You may also contact me directly and to discuss the matter in more detail.

Thanks,

-Sandy CAFP Dir. of Health Policy

With the help of the AAFP, promote family physicians as qualified hospitalists, and family medicine as an efficient and comprehensive model of hospital care. ER-1-07, 03/07 CoD Support Family Physicians to serve as hospitalists by a range of means that could include continuing medical education, job search, and promoting family physicians’ scope of practice to include hospitalist practice. ER-1-07, 03/07 CoD

Family medicine trained physicians are facing yet another unfair restriction, should they choose to become Hospitalist? This is especially true in Southern California it is not because we don’t have the training. Hospital contracts indicated Hospitalist to be Internal Medicine trained, not even mention that if you are a family medicine trained but have done a Fellowship as Hospitalist would be acceptable. Are we going to keep quiet again and let this be the rule? Or some one in our organization would raise our voice and do something about it?