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Autonomy as a Hospitalist PA


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Hello,

I wanted to know how much autonomy is given working as a hospitalist PA?  I know a physician has to admit a patient, or agree to the admission, but do PA's follow their own panel of patients while admitted, along with discharging them when medically appropriate (all without oversight or input by the physician)?   I have a friend who is currently working at a hospital, and after a patient is admitted, they allow him to follow his own panel of patients, including discharging them when they are deemed appropriate.  I am curious to know if this is common.

Thank you

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Short answer, yes.  There is a fair amount of autonomy as a hospitalist/inpatient provider. 

Longer answer, it depends.  It depends on your experience, the trust you have built with the physicians you work with, and the patient cohort you are seeing.  Rare times I'm covering non-ICU patients I admit from the ED or other service, develop a plan, implement that plan and then just give whatever attending is on a headsup at some point during the day.  On the more ICU level patients I normally do all of the same things but check in with the doc earlier in the process to make sure any input they have is used early on in the care.

Establish a high level of trust with the group you work with, know your stuff and yes, autonomy is definitely there.

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7 hours ago, MediMike said:

Short answer, yes.  There is a fair amount of autonomy as a hospitalist/inpatient provider. 

Longer answer, it depends.  It depends on your experience, the trust you have built with the physicians you work with, and the patient cohort you are seeing.  Rare times I'm covering non-ICU patients I admit from the ED or other service, develop a plan, implement that plan and then just give whatever attending is on a headsup at some point during the day.  On the more ICU level patients I normally do all of the same things but check in with the doc earlier in the process to make sure any input they have is used early on in the care.

Establish a high level of trust with the group you work with, know your stuff and yes, autonomy is definitely there.

This... I'm at a major academic center working on a PA-run Hospitalist service, after 7 years I've established a great working relationship and trust with the attendings; do my own admits and will usually run them by the Hospitalist the next day unless they're sick in which case sooner (but usually over the phone, not necessarily needing them to see the Pt). Attendings do need to approve discharges and have to see the Pt at least once before DC'ing. Do most of my own procedures (and teach the new Hospitalists), thora's/para's/LP's/lines. Most I know are in similar positions, but as stated above more rural locations allow for greater autonomy/solo coverage, etc...

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