Definition of attending physician

Can anyone help with finding an "official" definition of attending vs
admitting physician. We have used the traditional meaning of attending
being the provider who takes care of the patient while hospitalized.
Our nurses want to change it to the PCP. We have hospialists and the
PCP doesn't see the patient while hospitalized.Looking for some
supporting back up. Thanks

Sharon Busler, RHIA, MHA
Director of Health Information Services and Privacy Officer
Southern New Hampshire Medical Center
8 Prospect St.
Nashua, NH 03060
phone: 603-577-2340
fax: 603-577-5633
sharon.busler@snhmc.org

Most people are as happy as they decide to be

Comments

  • edited June 2016
    I have been looking for this recently myself and couldn't find much. I did find this in an old Huffman Medical Record Management book. "The attending physician who admits the patient is primarily responsible for care." This is the definition that we are using; however, we do allow the attending to transfer care to a consulting physician. The consulting physician then becomes the attending.

    Rhonda Willis, Director of Medical Records, Privacy Official
    La Porte Regional Health System
    219.326.2404
  • edited June 2016
    Have you looked at the uhdds definition?

    DeAnn Tucker

  • edited June 2016
    Good idea, I'll check it.


    Sharon Busler, RHIA, MHA
    Director of Health Information Services and Privacy Officer
    Southern New Hampshire Medical Center
    8 Prospect St.
    Nashua, NH 03060
    phone: 603-577-2340
    fax: 603-577-5633
    sharon.busler@snhmc.org

    Most people are as happy as they decide to be
  • edited June 2016
    Well, it was a good try. It only has definitions of the pr vs secondary
    dx and op, and other items, but none that describe the attending vs.
    admitting doc. I've been to the NCVHS website as well as the conditions
    of participation and they don't have anything either. I'm beginning to
    think there is no "official" definition - that it's been a traditional
    definition used by everyone.


    Sharon Busler, RHIA, MHA
    Director of Health Information Services and Privacy Officer
    Southern New Hampshire Medical Center
    8 Prospect St.
    Nashua, NH 03060
    phone: 603-577-2340
    fax: 603-577-5633
    sharon.busler@snhmc.org

    Most people are as happy as they decide to be
  • edited June 2016
    It is interesting that you are researching this topic. I have too recently. Our hospital began to look at it as we started generating case mix index reports by physician since we implemented a concurrent coding project in response to MS-DRGs. We wanted to use CMI as a measurement tool to determine the effectiveness of concurrent coding. I was concerned about using these reports when I had concerns about how the Attending was being selected. We had issues with physicians not completing order sheets on admission telling who was the Attending. There were many assumptions going on and not much thought of how this data could be used. We still have not resolved this issue. Our plan was to take a definition of the Attending and Admitting physician to our Med Exec Com. Well, when we began searching for definitions, we learned it was hard to find. So we asked some other sites in our area and we took their definitions and made some changes. Here is a draft and I don't know how we will come out on this. If others have more suggestions, I would be happy to hear them.:

    Proposed Definition for
    Attending and Admitting Physician

    Definition:
    The Attending Physician is responsible for managing patient care until the patient is transferred or discharged (HFAP). The attending physician:

    Manages the patient daily to provide continuity during the hospital stay. Monitors, by frequent verbal communication with the patient's nurse or case managers, the patient's progress, revising the care plan as indicated.

    Acts as a patient advisor and advocate regarding decisions on tests and therapies.

    Develops the post hospital care plan in a timely manner.

    Ensures the medical record is completed within the time period specified in the Medical
    Staff Bylaws/Policy/Procedure/Rules and Regs/Guidelines and contains sufficient information, including at least:
    chief complaint;
    provisional diagnosis;
    history of present illness;
    personal history;
    family history;
    system review;
    physical examination;
    progress note(s);
    final diagnosis;
    condition upon discharge; and,
    discharge summary.

    Informs the covering physician about patient status to fulfill the attending physician responsibilities in his/her absence.

    Definition:

    Admitting physician: The doctor responsible for admitting a patient to a hospital or other inpatient health facility.

    This physician is responsible for completing the history and physical when the admitting and attending physicians are two different people.

  • edited June 2016
    Thanks so much! I appreciate it. It's been terrible trying to find a
    uniform definition. Apparently, everyone puts their own spin on it. We
    use the attending/admitting designations when we reappoint docs to the
    medical staff, so activity volumes are crucial for this function. We
    have years and years in the database using the traditional definitions
    and now nursing is pushing to change it, which would render all our data
    useless. I really like this definition you are using - makes it very
    clear. Thanks again!

    Sharon Busler, RHIA, MHA
    Director of Health Information Services and Privacy Officer
    Southern New Hampshire Medical Center
    8 Prospect St.
    Nashua, NH 03060
    phone: 603-577-2340
    fax: 603-577-5633
    sharon.busler@snhmc.org

    Most people are as happy as they decide to be

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