You are correct about the more corporate structure of medical care today and how it has compartmentalized care to the extreme. However, there are still PCPs in private practice, as well as other physicians, that still have privileges for certain hospitals and in certain cases are still the attending physician - although they are becoming fewer in number over time. PCPs are often the last line of defense in fighting for their patients. I have personally been involved in battles with hospitals over patient care. It has really come to a head with covid. Some providers have had their privileges revoked because they tried to intervene and buck the hospital when trying to advocate for their hospitalized patients.

Over time the inpatient responsibilities have been kicked to the hospitalist rather than the patient's personal MD. There is good and bad with this system. In the case with critical care, the intensivist basically has complete control over what happens with a patient from the time the patient enters the ER. The last link of advocacy for the patient, which is their own personal provider, has being dismantled. The hospitalist and the intensivist work for the hospital. Because there is no patient advocacy, we now find ourselves in a crisis. Just talked to someone today who's friend escaped from a hospital after he had been vented. One of the staff must have missed giving him his dose of meds and he woke up. This is not the first time I have heard of such cases. I prefer to keep people out of the hospital and so far so good.

The hospital landscape has changed and patients need to understand they are not dealing with the old system any longer. That system quietly went away when they were not watching. Unfortunately for many, they had to come to this realization when a loved one became hospitalized with covid, or they were hospitalized for some other reason and then tested positive, and now they are living the nightmare of medical kidnapping. It is sad and frightening.