Dr Williams has written an impassioned advertisement for hospital medicine. Unfortunately, he focuses mostly on studies that put hospitalists in a positive light. Not all studies share these findings.1 We cannot exclude the problem of publication bias when we review studies looking at how hospitalists have an impact on patient care.
As I wrote in my original discussion, the phrase "hospitalist inpatient system" does not describe a homogeneous concept. Hospitalist groups vary in call structures and accessibility. Academic hospitalists often have very different responsibilities than community hospitalists. We need to understand the influence of these various systems on the measurement of hospitalist impact.
We also do not know how much the individual physicians affect patient care outcomes. I suspect that we all believe that some physicians consistently do a better job of patient care than do others.
We do know that hospitalists (in varied forms) have . . . [Full Text of this Article]
