Commentary on the Effect of Hospitalists on Paient Care

The hospitalist is a means to increase the efficiency of hospitals by achieving equal or better outcomes of care while reducing the cost of care. I comment on Dr. Meltzer's controlled study of the costs and outcomes of hospitalist care, which showed increased cost-savings and no change in patients' satisfaction with their care. Relative to full-time community practice, Dr. Meltzer's findings probably exaggerate the effect of hospitalists on costs and minimize differences in satisfaction with care. The physicians in charge of the control group of patients were full-time academic faculty, who typically spend one or two months per year doing in-patient care, in contrast to the hospitalists who spent most of their time caring for hospitalized patients. Resident physicians did most of the bedside care for the hospitalist patients and the control group patients, an arrangement that would reduce any intrinsic differences