As I re-read the New York Times article on hospitalists and surveyed blog reactions something else struck me. For all the uncritical praise of hospitalists for their value as business solutions there was not one word about what I think is really special about hospitalists: superior clinical skills developed on the ascent of the steep learning curve of caring for horribly ill patients day in and day out. Nothing about septic shock, respiratory failure or decompensated heart failure and the nuances of care. The Times even went so far as to characterize the specialty as a “breed of physician-administrator.” That was not a founding principle. If true, the field is devolving.
With the exception of a few negative anecdotes DB's and my reactions were the only critical blog posts I found. Most were mere regurgitations of the Times piece. The few that stood out were credulous in their praise. Bob Wachter thought the article hit the right notes. This post was effusive with unsubstantiated claims about the movement. So, good intentions may ultimately damage the movement, paving the way to misplaced expectations and false attributions.