|Image source: Wikipedia. |
Creative Commons license 3.0.
Attribution: Jim Accordino
It's not that they aren't liked. Referring docs and hospital staff love them. But as DB pointed out in one of his recent posts, hospitlaists are increasingly being regarded as advanced residents. It wasn't always that way. At the inception of the movement hospitalists were appreciated mainly for their clinical expertise in the uniquely complex aspects of the care of very ill inpatients. At the time the name of their professional organization, the National Association of Inpatient Physicians (NAIP) better reflected that. Since then clinical expertise has been devalued as hospitalists have increasingly been viewed as business solutions and providers to off-load the clerical work and rounding duties from other services. As hospital medicine has devolved into the Swiss Army knife model it has become a mile wide and an inch deep. The Society of Hospital Medicine has, unfortunately, pushed the field in this direction.
I'm sure that in his travels and speaking engagements DB interacts with a large cross section of hospitalists. One gets the sense from his post that hospital medicine is becoming less professionally satisfying for many of them.