The Feb 03, 2006 issue of Medical Economics has a interesting discussion of why the tradition of the doctors lounge is dying out. This seems to be something else we can blame managed care for.The authors cite managed care and the rise of the hospitalists as causes. I would spin it this way: the hospitalist movement is in no small measure also a indirect result of managed care.
How does that work? With managed care driven reimbursement decrements it economically behooved primary care docs to see more patients in the office as the pay per patient- encounter decreased.The hospitalist-according to Dr. Wackter-sprang up because their presence allowed the primary care docs to see more office patients by not having to round at the hospital.
Dr. Robert Wachter's version of how hospitalists appeared on the scene is found here and it will likely be the historical orthodoxy. Further, the days of the doctors' lounge being the primary site for networking and consulting each other are largely gone as the physicians that other docs refer to is largely determined by what plan the patient has.
This ties in with an earlier blog I wrote that discussed the observation that not only has managed care driven a wedge between doctor and patients but it has also did the same thing between physicians leading to a gradual withering away of the collegiality that in the best of times existed in the medical profession. I think the demise of the doctors lounge is symbolic of all of that.
The local internal medicine society that I have belonged to for over 25 years once had 75 or more in attendance at our monthly meetings,now has maybe 20 on a good night and usually the older and retired docs are in the majority.The younger internists who in part came to the meetings to become known and make important networking links see no need to do so now. It is basically attended by a few academic internists who are in the med center anyway at that time of day and the retired docs who don't have anything else to do. I believe the demise of this professional organization is probably another victim of managed care.