I wish to comment on the article by Redelmeier1 concerning the hospitalist movement. I am a general internist who has practiced for nearly 40 years. I was trained as a specialist but now am considered a primary care physician. This is a situation that many general internists now face.
I have many concerns about the hospitalist movement. For years I have maintained an extremely busy office practice in combination with a heavy inpatient load. Redelmeier, I believe, omits a very serious consideration: the erosion of clinical skills that occurs if the physician is limited to outpatient practice. My intellectual stimulation and clinical abilities are primarily maintained by interaction in a hospital setting.
Echikson AB. The Hospitalist Movement. Arch Intern Med. 2000;160(4):552. doi: