| May 27, 2008
Dr. RW: “The bubble will burst the morning CEOs wake up and realize that there is no longer a shortage of hospitalists. Don’t expect that to happen for decade or so according to the panel.”
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I have long beeen a sole dissenting voice in the hospitalist debate; I do not think the model will last. Most hospitalist programs are subsidized under the argument that they save money. However, this has not been proven in a significant way. Eventually, they will have outasted their usefulness and be replaced either by cheaper hospitalist midlevel providers or by the primary care doctors returning to hospital care (not subsidized).
Somehow, I just don’t see my usefullness being outlasted. I always laugh at the assertion that internal medicine can be practiced independently by midlevels. That’s like saying a midlevel can do a Whipple independently, or a midlevel can perform a laminectomy independently. That’s simply not the case. Perhaps heart catheterizations. Maybe colonoscopies. Your assertion, surely isn’t limited to hospitalist medicine. I assume you believe the trend toward midlevels will progress in all specialties. If that’s the case, may our health be with us.
I was a hospitalist for 5 years at a major New York hosp[ital. Their solution for getting themost for their money was by having us do a lot of non-hopsitalist work.. i.e. teach physical diagnosis to med students, farm us out to a nursing home, cover a dedicated service for a certain insurance company. It sucked, which is why I left. They say the average life span of a hospitalist is 5 years. There’s a reason.
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