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Echikson makes claims with which I sympathize. Yet others might think differently. Claims about clinical skills eroding in outpatient practice are disputable, as are claims about the talent of inpatient physicians. Claims about intellectual stimulation are also controversial, given the potential complexities of outpatients. Claims about hospital loyalty are also contentious if a physician's first duty is to the patient.
The incontestable claim is the comment on isolation. I agree that outpatient medicine sometimes has a lonely character. Close patient contact is rewarding, but collegial dialogue can be infrequent. In contrast, a hospitalist practice involves team efforts and the interactions of many health care professionals (a style not suited to all clinicians). Each physician should keep in mind which best fits his or her personality.
Redelmeier DA. The Hospitalist Movement—Reply. Arch Intern Med. 2000;160(4):552. doi: