Home Commentary hos-pi-tal-ism: Should we claim the word for our own?

hos-pi-tal-ism: Should we claim the word for our own?

January 2008

Published in the January 2008 issue of Today’s Hospitalist

Fans of “Seinfeld ” are very familiar with the idea of a show about nothing. Thus inspired, here is a commentary about nothing.

I was recently writing an entry for the Today’s Hospitalist blogs when I found the occasion to use the word “hospitalism,” which seemed to obviously denote the practice of hospital medicine. When a friend who was editing my blog told me I had just made up a word, we placed a small, friendly wager and went off to dictionary.com.

Yes, it is a real word, which surprised my friend. But it was an even bigger surprise to me that I could not have been using the word in a more incorrect context.

The Merriam-Webster’s Medical Dictionary defines hospitalism, a noun that dates back to 1865, as follows: “1 a: the factors and influences that adversely affect the health of hospitalized persons; b: the effect of such factors on mental or physical health. 2: the deleterious physical and mental effects on infants and children resulting from their living in institutions without the benefit of a home environment and parents”.

Encyclopedia.com gives the history of the word as follows: “hospitalism n. A term introduced in 1945 by the Austrian psychoanalyst René A. Spitz (1887’1974) to denote the physical and psychological effects on an infant (up to 18 months old) of prolonged and total separation from its mother, due to hospitalization or some other similar cause. According to Spitz, the characteristics include retarded physical development and disruption of perceptual-motor skills and language.”

A Google search finds the word being used and misused “and rather hilariously so “in several articles about hospitalists. Here’s a sample of titles: “Is Hospitalism New?”, “The rising tide of hospitalism: evidence-based or anecdote-based medicine?” and my favorite, “Hospitalism has taken hold in internal medicine across the nation.” I even found an abstract of an article by a highly regarded physician, Dr. Lee Goldman, who writes about the history of medicine. His article was aptly titled, “Hospitalists as cure for hospitalism.”

Based on its current definition, hospitalism would be correctly used in the following sentence: “I went to the hospital, was treated by a hospitalist, and developed severe mental anguish and physical pain due to hospitalism.”

Wow, we really do need to update this word! Thanks to Dr. Bob Wachter, we now have a word, hospitalist, to define our field. Using the same proprietary spirit to an infinitely less significant end, perhaps it’s time for us to add this new definition for hospitalism: “The beliefs or practices of physicians who specialize in treating hospitalized patients.”

I am pretty sure that, unlike Dr. Wachter, I won’t be given a platform in the New England Journal of Medicine to introduce the new definition. But watch out, Wikipedia!

Erik DeLue, MD, authors a blog on TodaysHospitalist.com that examines the challenges of running-and reinventing-a hospitalist program, a situation that a growing number of hospitalist services now face. He is medical director of the hospitalist program at Virtua Memorial Hospital, a hospital in Mt. Holly, N.J.