Wednesday, October 08, 2014

Hospitalist medicine: primary care medicine's deal with the devil

Rob Lamberts, a clinic based physician who some time ago began turning his inpatients over to hospitalist care recently posted in the ACP Hospitalist blog concerning his experience with the model. The picture he paints here is one of fragmented communication, bewildered patients and downright poor care.

We have to be careful about generalizations. This is an anecdote, and not all hospitalist programs function this way. There are some good ones and some bad ones. But I've heard this story before from many settings. Why does this problem persist even as the hospitalist movement has matured over almost two decades? The answer that first comes to mind is the discontinuity of patient care that is built into the model but that's only a small part of the problem. The real problem is that the field of hospital medicine has become so bogged down with useless metrics and artificial quality surrogates that it has neglected the old fashioned basics of excellent patient care.

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