Dr. Donald Thomas, Chief of Staff at the hospital sought to dispel myths about the new hospitalist programme which has qualified internists not training staff taking care of patients.

The hospitalist programme was introduced to the King Edward VII Memorial Hospital in July this year in an attempt, according to Health Minister Nelson Bascome to increase quality of care and therefore decrease the length of stay.

Serious concerns however have been raised by the general practitioners on the Island who are worried they will no longer be able to treat their hospitalised patients because they do not have access to the house officers.

Dr. Thomas explained that the GPs who elected to care for their patients could both use the hospitalists for admitting their patients and caring for them in an emergency until the doctor can reach the hospital.

But more oversight needed to be given to the house officers, which now fall under the supervision of the hospitalists.

He said: "The programme was not instituted to take away the house officers, but to offer better services and quality control on the house staff.

"It was not done to disenfranchise them (family practitioners). We require house staff have to have at least two years of internal medicine training.

"GPs and family practitioners don't have that much time on internal medicine. I cannot have someone with less time supervising somebody who you consider not finished training.

"That's just a structural problem. I cannot recommend something I would not use for my own family. We are going to increase the quality of the care."

According to a letter to the editor in the Mid Ocean newspaper by Herman Tucker, the chairman of the Bermuda Hospitals Board, the GPs would still have privileges, but house officers would no longer be able to admit patients.

There are now five internists employed in the hospitalist programme — one Bermudian who was trained in the UK is in charge, two are from America and two are from Jamaica.

And all five are Board certified or registered, according to Dr. Thomas.

Under the new programme, when patients are admitted into the hospital they will be asked whether or not they want to use their GP or the hospitalist.

If they want to use their GP the hospitalist will still do the admitting, but can then transfer the patient to their doctor's supervision while they are in the hospital.

However, Dr. Thomas added, if the family practitioner also decides they are unable to treat their clients while they are hospitalised, KEMH cannot force them to do that.

"If the family practitioner does not want to take care of them in the hospital we cannot force them to do so.

"They may end up on the hospitalist programme even if they say they do not want it," he added.

"That's the way it's done in most places in the world. Pick a place in North America and if it's not a training hospital that's the way it's done.

"We are still in deliberations with them about this internist programme, but the first thing is the safety and care of the patients.

"Going back to the old system because it has been around for 30 years is not a reason, not to change.

"We had 44 or 45 GPs giving them different directions. Now we have five all trained the same way. They operate the same way. There is much more consistency in their supervision.

"We will eventually have protocols where we have a standard of care that's homogeneous. Protocols with evidence based practices and standards."