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Improved Outcomes in a Voluntary Hospitalist Model
- Andrew D. Auerbach, MD, MPH;
- Robert M. Wachter, MD; and
- Lee Goldman, MD
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
IN RESPONSE:
We disagree with the statement that “if doctors know that one of their explicit goals is to expedite patient discharge, it will happen.” The site of our study was indeed experiencing financial difficulties, but these difficulties were visible to all physicians and expedited discharges were a priority for everyone. However, only hospitalists were able to improve clinical efficiency while simultaneously improving patient outcomes.
The traditional model may preserve continuity, but at the price of inefficient care and, perhaps, poorer outcomes (1). Notwithstanding the shortcomings of our study or others, many outpatient-based generalists now routinely refer their inpatients to hospitalists, a pattern cemented by their satisfaction with the model's positive effects on their patients and practice (2). As a result, hospital care from a hospitalist is routine—a hospitalist is yet another “specialist” to whom patients are referred. Thus, the more relevant challenge to our specialty is how we can retain closeness and continuity in all generalist–specialty interactions, not only those in which hospitalists are involved.
Andrew D. Auerbach, MD, MPH
Robert M. Wachter, MD
Lee Goldman, MD
University of California, San Francisco; San Francisco, CA 94143
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
