The Hospitalist Movement in the United States: What Does It Mean for Internists?

A nnals is pleased to publish a supplement on the hospitalist movement in the United States to accompany this issue of the journal. It contains 10 articles developed from presentations at a national policy conference of the new National Association of Inpatient Physicians held in December 1997 in San Francisco. This fledgling professional organization, a formal affiliate of the American College of Physicians-American Society of Internal Medicine, has become a major nidus of activity in the rapidly changing landscape of inpatient medical care.

The term “hospitalist” was first introduced in 1996 to describe physicians who devote much of their professional time and focus to the care of hospitalized patients (1). However, hospital-based specialists, like those in infectious disease or critical care, have been around for a long time in both the United States and abroad. Many group practices assign a single physician in the group, most often on a rotational basis, the task of rounding on the all of its inpatients. In other settings, so-called “house physicians” other than traditional housestaff are hired to oversee inpatient care, handle emergencies, and carry out the treatment plans of the attending physician. But the new paradigm of today's hospitalist revolves around the notion of the mandatory hand-off of inpatient care responsibility from the patient's own doctor to an entirely new and autonomous physician free of the competing priorities of …