Comments on: Hospitalists assimilate inpatient medicine, is resistance futile? http://www.kevinmd.com/blog/2009/03/hospitalists-assimilate-inpatient.html Tue, 14 Feb 2012 22:04:00 +0000 hourly 1 By: Christian Molstromhttp://www.kevinmd.com/blog/2009/03/hospitalists-assimilate-inpatient.html#comment-90308 Christian Molstrom Mon, 16 Mar 2009 06:24:00 +0000 http://clients.emmense.com/kevinmd/2009/03/hospitalists-assimilate-inpatient-medicine-is-resistance-futile.html#comment-90308 I've always wondered about the economic feasibility of the hospitalist model. Most hospitalists do very few procedures, making relatively little money for the hospital. However, I would like to know if specialist/proceduralist referal rate is higher among hospitalists compared to GPs or FPs. <br/><br/>Reading Dr. Wachter's original comment in the post above makes me wonder if he did not envision a hospitalist that was really a jack of all trades only rarely utilizing the specialist. I’ve always wondered about the economic feasibility of the hospitalist model. Most hospitalists do very few procedures, making relatively little money for the hospital. However, I would like to know if specialist/proceduralist referal rate is higher among hospitalists compared to GPs or FPs.

Reading Dr. Wachter’s original comment in the post above makes me wonder if he did not envision a hospitalist that was really a jack of all trades only rarely utilizing the specialist.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2009/03/hospitalists-assimilate-inpatient.html#comment-90303 Anonymous Mon, 16 Mar 2009 01:35:00 +0000 http://clients.emmense.com/kevinmd/2009/03/hospitalists-assimilate-inpatient-medicine-is-resistance-futile.html#comment-90303 "The way I see it, the hospitalist model increases efficiency and decreases length of stay."<br/><br/>Stop drinking the kool aid.<br/>This has not been shown to the be the case in major studies.<br/>Prove it. “The way I see it, the hospitalist model increases efficiency and decreases length of stay.”

Stop drinking the kool aid.
This has not been shown to the be the case in major studies.
Prove it.

]]> By: The Happy Hospitalisthttp://www.kevinmd.com/blog/2009/03/hospitalists-assimilate-inpatient.html#comment-90299 The Happy Hospitalist Sun, 15 Mar 2009 21:24:00 +0000 http://clients.emmense.com/kevinmd/2009/03/hospitalists-assimilate-inpatient-medicine-is-resistance-futile.html#comment-90299 Or all specialty groups will move to the hospitalist model. It's one or the other. <br/><br/>The way I see it, the hospitalist model increases efficiency and decreases length of stay. If anything, that means hospitals will look to hospitalists to see ALL patients in the hospital, not fewer.<br/><br/>If hospitalists go bankrupt, that means out patient docs will as well and the whole system will implode. It will not matter if you are an out patient doc or a hospitalist model doc. Unless, of course you see only cash paying "customers" Or all specialty groups will move to the hospitalist model. It’s one or the other.

The way I see it, the hospitalist model increases efficiency and decreases length of stay. If anything, that means hospitals will look to hospitalists to see ALL patients in the hospital, not fewer.

If hospitalists go bankrupt, that means out patient docs will as well and the whole system will implode. It will not matter if you are an out patient doc or a hospitalist model doc. Unless, of course you see only cash paying “customers”

]]> By: The Happy Hospitalisthttp://www.kevinmd.com/blog/2009/03/hospitalists-assimilate-inpatient.html#comment-90298 The Happy Hospitalist Sun, 15 Mar 2009 21:21:00 +0000 http://clients.emmense.com/kevinmd/2009/03/hospitalists-assimilate-inpatient-medicine-is-resistance-futile.html#comment-90298 <a HREF="http://thehappyhospitalist.blogspot.com/2009/03/57-million-dollar-hospitalist-advantage.html" REL="nofollow">The 57 Million Dollar Hospitalist Advantage</a> The 57 Million Dollar Hospitalist Advantage

]]> By: Bad Medicine, Good Solutionshttp://www.kevinmd.com/blog/2009/03/hospitalists-assimilate-inpatient.html#comment-90294 Bad Medicine, Good Solutions Sun, 15 Mar 2009 16:12:00 +0000 http://clients.emmense.com/kevinmd/2009/03/hospitalists-assimilate-inpatient-medicine-is-resistance-futile.html#comment-90294 The hospitalist movement will last only as long as the government continues the status quo of procedural medicine. Hospitalists reduce length of stay. That's it. They increase the rate of turnover which increases a hospitals ability to proceduralize patients, and as a result their salaries are subsidized. Once the procedural favorability is gone, or medicare simply goes bankrupt, hospitals will have no gravy train. They will start going bankrupt (as some are starting to do now). ERs will start testing what the true bare minimum of EMTALA really is that they can get away with. As hospitals once again are forced into a market that doesn't have the means of cost shifting, subsidizing hospitalists will be a fools errand. IM/FP will flee the hospitals and function as traditional PCPs once again. <br/><br/>Summary: Hospitalists exist because of the current payment model. When it ends, so will hospitalists. The hospitalist movement will last only as long as the government continues the status quo of procedural medicine. Hospitalists reduce length of stay. That’s it. They increase the rate of turnover which increases a hospitals ability to proceduralize patients, and as a result their salaries are subsidized. Once the procedural favorability is gone, or medicare simply goes bankrupt, hospitals will have no gravy train. They will start going bankrupt (as some are starting to do now). ERs will start testing what the true bare minimum of EMTALA really is that they can get away with. As hospitals once again are forced into a market that doesn’t have the means of cost shifting, subsidizing hospitalists will be a fools errand. IM/FP will flee the hospitals and function as traditional PCPs once again.

Summary: Hospitalists exist because of the current payment model. When it ends, so will hospitalists.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2009/03/hospitalists-assimilate-inpatient.html#comment-90293 Anonymous Sun, 15 Mar 2009 12:53:00 +0000 http://clients.emmense.com/kevinmd/2009/03/hospitalists-assimilate-inpatient-medicine-is-resistance-futile.html#comment-90293 Interesting that the trend was NOT observed with family physicians, only with internists. This mirrors my own community, where almost all of the internists utilize hospitalists, and almost none of the family physicians do. The difference is philosophical. <br/><br/>It is also interesting that there is no mention in the post of hospitalists saving money and/or improving quality. Very few studies have shown this, and most show no significant difference at all. The true motivation behind the hospitalists movement was always the lifestyle of the physicians involved, so it is time to stop mixing the kool aid.<br/><br/>A family practitioner Interesting that the trend was NOT observed with family physicians, only with internists. This mirrors my own community, where almost all of the internists utilize hospitalists, and almost none of the family physicians do. The difference is philosophical.

It is also interesting that there is no mention in the post of hospitalists saving money and/or improving quality. Very few studies have shown this, and most show no significant difference at all. The true motivation behind the hospitalists movement was always the lifestyle of the physicians involved, so it is time to stop mixing the kool aid.

A family practitioner

]]>