It’s been 21 years since Drs. Robert Wachter and Lee Goldman, in an article in the New England Journal of Medicine, first described a new delivery model called “hospitalists” – clinicians whose primary professional focus is the care of hospitalized patients. Since that time the healthcare system has seen rapid growth of hospitalist programs across a variety […]

It’s been 21 years since Drs. Robert Wachter and Lee Goldman, in an article in the New England Journal of Medicine, first described a new delivery model called “hospitalists” – clinicians whose primary professional focus is the care of hospitalized patients. Since that time the healthcare system has seen rapid growth of hospitalist programs across a variety of specialties.
In the OB world, I have had the opportunity to observe the entire transition from both sides. In my opinion, the addition of a unit (OB emergency department, or OBED) where every patient presenting to labor and delivery for unscheduled care is seen by a provider capable of doing a medical screening exam and handling the worst emergency as a first responder is a critical supplement to patient safety.
It should also be acknowledged that changing the status quo can be disruptive. For better or worse, disruption breeds resistance. A well-known primary care physician recently criticized “hospital-based doctors who know nothing about the patients for whom they care” – which suggests that there is residual suspicion, or perhaps professional competition, regarding what hospitalists actually do. This opinion does not account for the fact that the two roles are different and complementary.
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