Home From The Editor Has hospital medicine reached a turning point?

Has hospital medicine reached a turning point?

February 2008

Published in the February 2008 issue of Today’s Hospitalist

That question came to mind while I was reading the results of the latest “and largest to date “study to compare the performance of hospitalists to office-based internists and family physicians. While the study, which was published late last year in the New England Journal of Medicine, found that hospitalists did indeed reduce length of stay and costs, those gains weren’t nearly as impressive as documented in previous studies.

Because many hospital administrators have looked to hospitalists to make their operations leaner, in part by reducing costs, the latest study could be bad news. But most of the hospitalists we talked to for this month’s cover story have a very different take on the subject.

They admit that while the length-of-stay reductions are not as stellar as most of the single-site studies that have come before, they are still significant. But the even bigger message seems to be that because hospitalists bring so much value above and beyond their ability to control costs “improving patient safety, meeting public reporting requirements, treating uninsured ED patients “that these study results will be nothing more than a speed bump in the specialty’s growth.

If that’s true, it means that hospital medicine has reached something of a turning point. (Be sure to read one hospitalist’s commentary on “the five stages of hospital medicine”.) Hospitalists are no longer viewed as simply levers to control costs. Instead, they’re finally being recognized for the range and depth of value they bring to inpatient medicine.

While this is good news, it also challenges hospitalists to do more than reduce length of stay. The study confirms what many of you already know: Reducing length of stay is a great start, but it’s not going to be enough. What is your group doing to meet this challenge?

edoyleEdward Doyle
Editor and Publisher