Friday, March 13, 2009

It’s official: the hospitalist movement has taken over

For good or ill, with all its benefits and unintended consequences, it’s now official: Bob Wachter, who gave the original movement life by coining the term, has spoken:

…hospitalists have not only taken over for PCPs in overseeing and coordinating hospital care, they have taken over for specialists and subspecialists.


The bottom line is that the rotating PCP model might work here and there, and it is probably better than the traditional model of every PCP coming in every day at daybreak to see 1-2 very sick patients. That said, I believe that calls for its revival represent wistful longings for a system that has clearly lost in the marketplace of ideas and data that determines the organization of hospital care.

Ah, the beloved hospitalist model. Never has been “evidence based”, never will be, here to stay, it is what it is.

I’ve been saying for a long time that the endless and tiresome discussions about the hospitalist model’s value were irrelevant and that it was all about the niche. That position now seems to be “official.”

The NEJM paper Bob cites as possibly the final finishing blow to the old model is interesting and I may have more to say about it later.

St. Louis City Hospital, decaying, c. 1995, years after doctors left the building

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