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Invited Commentary
December 2017

The Costs and Benefits of Hospital Care by Primary Physicians: Continuity Counts

Author Affiliations
  • 1Department of Medicine, University of Alabama at Birmingham
JAMA Intern Med. 2017;177(12):1788-1789. doi:10.1001/jamainternmed.2017.5833

In 1948, LIFE magazine published the “Country Doctor” (http://time.com/3456085/w-eugene-smiths-landmark-photo-essay-country-doctor/), the photographic essay by W. Eugene Smith that established the iconic American physician as one who provides comprehensive care for his or her patients wherever they were, whenever they were needed. In Kremmling, Colorado, Dr Ernest Ceriani cared for people at home, in the office, and in the hospital, sometimes carrying them bodily from one place to another. Since 1948, times have changed, and comprehensive care with continuity in the relationship of a patient with “my doctor” has decreased, especially during inpatient hospital care. In 1996, Wachter and Goldman1 heralded the emerging role of hospitalists, and the proportion of general medicine inpatient services attributed to hospitalists has increased rapidly, from 9% in 1995 to 37% in 2006 and 58% in 2013.2,3