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July 24, 1987

Worlds ApartSome Thoughts to Be Delivered to House Officers on the First Day of Clinic

JAMA. 1987;258(4):502-503. doi:10.1001/jama.1987.03400040100030

WELCOME to the University Hospital outpatient department. We'd like to take a few minutes to orient you to the clinic, and to make your rotation here more rewarding by pointing out some of the differences between inpatient and outpatient medicine. During the next few years, outpatient medicine will become increasingly important. Because hospitals are so expensive, they are being used less often for extensive inpatient evaluations. As a result, medical care has tended to move here, to the outpatient clinic, where care will continue to be less expensive for most illnesses in which there is an option, even if—as many expect—prospective payment or capitation is widely adopted for use in the outpatient clinic. But both medicine and patients have much to gain by this shift. Outpatient medicine has the potential to be more effective in improving people's health than inpatient medicine. It is where most patients see doctors and where