Hospital privileges for family physicians. Patterns of recent residency graduates, residency director perceptions, and resident expectations

A national mail survey was performed that examined reports of recent residency graduates about hospital privileges for family physicians, perceptions of residency program directors about the percentage of their graduates who obtain privileges, and plans of third-year residents for seeking privileges. Privileges in medicine, pediatrics, surgery, obstetrics, and coronary care/intensive care units (CCU/ICU) were examined. Questionnaires were mailed to a random sample of 308 residency graduates aged 30 to 35 years, all 383 family practice residency directors, and a random sample of 319 third-year residents. Two mailings produced an 82 percent response rate. Most recent graduates had privileges in medicine (97 percent), pediatrics (95 percent), and CCU/ICU (87 percent). A majority (64 percent) had obstetric privileges, and a minority (36 percent) had surgical privileges. Directors were accurate in their perceptions of privileges attained by graduates in medicine, pediatrics, and CCU/ICU, but underestimated the percentage who had privileges in surgery and overestimated the percentage who had privileges in obstetrics. Residents planned on seeking privileges in medicine, pediatrics, and obstetrics at a rate similar to recent graduates, with lower percentages planning on seeking them in surgery and CCU/ICU. Privileges in surgery and obstetrics were more prevalent in the Midwest and West.