The study also may ease concerns of residents that the increasing involvement of hospitalists could cost them their autonomy and compromise the quality of their education, Wachter said. A survey showed that a majority of residents who worked side-by-side with the hospitalists were highly satisfied with the experience. In fact, the majority preferred it to the traditional system.
Also allayed were the concerns of other specialists, who questioned whether they would get fewer referrals as a result of greater reliance on hospitalists, Wachter said.
The findings, Wachter said, further support the increasingly popular idea of using hospitalists to improve the efficiency, and possibly the quality, of inpatient care. The concept of the dedicated inpatient physician was first described by Wachter and co-author Lee Goldman, MD, UCSF professor of medicine and chair of the UCSF Department of Medicine, in a seminal 1996 New England Journal of Medicine article, in which the term "hospitalist" was coined.
While improving value may not have been a primary focus as little as five years ago, managed care now forces health care providers to look for ways to cut costs without harming quality or patient satisfaction, Wachter said.
"Nearly two years after the study, the practice of having attending physicians being involved sooner and more intensely makes up the majority of the way things work now," Wachter said. "Now these methods are standard procedure."
Co-investigators include Goldman; Patricia Katz, PhD, UCSF assistant professor of medicine; Jonathan Showstack, PhD, MPH, UCSF professor of medicine; and Andrew Bindman, MD, UCSF associate professor of medicine.
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Contact: Diana Marszalek
dmarsza@itsa.ucsf.edu
(415) 476-2557
University of California - San Francisco
19-May-1998