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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

I wish to comment on the article by Redelmeier¹ concerning the hospitalist movement. I am a general internist who has practiced for nearly 40 years. I was trained as a specialist but now am considered a primary care physician. This is a situation that many general internists now face.

I have many concerns about the hospitalist movement. For years I have maintained an extremely busy office practice in combination with a heavy inpatient load. Redelmeier, I believe, omits a very serious consideration: the erosion of clinical skills that occurs if the physician is limited to outpatient practice. My intellectual stimulation and clinical abilities are primarily maintained by interaction in a hospital setting.

I believe abandoning inpatient care will markedly diminish the abilities of physicians to keep current with the rapidly changing technology of medicine. I believe it will also isolate the physician from contact with peers and specialists. On a . . . [Full Text of this Article]

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A Canadian Perspective on the American Hospitalist Movement
Donald A. Redelmeier
Arch Intern Med. 1999;159(15):1665-1668.
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