Re: Ah, the good ol’ days

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


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.

Scott D. Smith, MD, CCFP, MSc. Re: Ah, the good ol’ days. BCMJ, Vol. 58, No. 7, September, 2016, Page(s) 358 - Letters.

Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.

For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit

BCMJ Guidelines for Authors

Leave a Reply