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Controversies in Internal Medicine
June 23, 2008

Rebuttal

Author Affiliations
 

ANN B.NATTINGERMD, MPH

Arch Intern Med. 2008;168(12):1260. doi:10.1001/archinte.168.12.1260

Dr Williams has written an impassioned advertisement for hospital medicine. Unfortunately, he focuses mostly on studies that put hospitalists in a positive light. Not all studies share these findings.1We cannot exclude the problem of publication bias when we review studies looking at how hospitalists have an impact on patient care.

As I wrote in my original discussion, the phrase “hospitalist inpatient system” does not describe a homogeneous concept. Hospitalist groups vary in call structures and accessibility. Academic hospitalists often have very different responsibilities than community hospitalists. We need to understand the influence of these various systems on the measurement of hospitalist impact.

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