By: Scott D. Smith, MD, CCFP, MSc
Re: Ah, the good ol’ days
Issue: BCMJ,
vol. 58, No. 7, September 2016,
Page 358 Letters
The editorial “Ah, the good ol’ days. Nary an orphan in sight.” (BCMJ 2016;58:244) provided a simplistic description of the growth of hospital medicine (a.k.a., hospitalist programs) in BC. It also included a number of misleading statements.
For example, the author claims that “patients who were cared for by their own GP had shorter hospital stays” than those cared for by hospitalists. No references are provided to support this claim. In fact, numerous studies in the United States, and some limited evidence from Canada, have shown the opposite—hospitalists reduce length of stay compared to nonhospitalists,[1-3] while reducing hospital costs and possibly also improving quality of care.
There are clearly advantages to the traditional model of inpatient care provided by a patient’s own GP. Good continuity of care is the most obvious example. I have great respect for the dedication of my GP colleagues who maintain busy community practices as well as hospital privileges. The medium-sized community where I work is fortunate to have a strong hospitalist department that has regular contact and an active collegial relationship with the community-based family physicians, both those with and without active hospital privileges.
—Scott D. Smith, MD, CCFP, MSc
Hospitalist, Kelowna
References
1. Rifkin WD, Holmboe E, Scherer H, Sierra H. Comparison of hospitalists and nonhospitalists in inpatient length of stay adjusting for patient and physician characteristics. J Gen Intern Med 2004;19:1127-1132.
2. Lindenauer PK, Rothberg MB, Pekow PS, et al. Outcomes of care by hospitalists, general internists, and family physicians. N Engl J Med. 2007;357:2589-2600.
3. Yousefi V, Wilton D. Re-designing hospital care: Learning from the experience of hospital medicine in Canada. J Global Health Care Systems 2011;1:2-10.