More discussion on the hospitalist movement

Not long ago Aggravated DocSurg wrote a very negative post about the hospitalist model of care. I responded here and acknowledged that DocSurg had raised some important issues that hospitalist leaders need to address. Then Flea weighed in with these two posts and said:

There is no more stinging indictment of the hospitalist phenomenon than this: The patients hate it. They want to be cared for by their own doctors. When will the peeps speak up and tell the hospitals they hate the hospitalists? If the powers that be won't listen to the fleas, perhaps they'll listen to the customers.

I must respectfully question that assertion and again point out that a collection of anecdotes does not equal evidence. The best evidence that I’m aware of comes from this systematic review of hospitalist outcomes. Of the 19 papers in the review 4 reported on patient satisfaction. In all 4 of those studies no difference in patient satisfaction was found between the hospitalist model and the traditional care model. From the patient’s point of view the disadvantage of hospitalist care, discontinuity, may be counterbalanced by the fact that the hospitalist is “there” all day, can make frequent re-visits when necessary and may be more accessible to families.