Re: The hospitalist program

Issue: BCMJ, vol. 46, No. 3, April 2004, Page 113 Letters

I was in a family practice office for 24 years until I became a Burnaby hospitalist 3 years ago. As I see it there are various reasons for the hospitalist program [see BCMJ 2003;45:391–394 and 2004; 46:7–9]. The main reason is the changes that have occurred across North America in health care. Back in the 1980s, things were different. We had our obstetric patients and their babies in hospital for 5 days; appendectomies and hernias were in 5 days; infections were treated in hospital and not by outpatient or home IV; there were more sick hospitalized children, and on and on. The end result is that, across the medical disciplines from family practice to internal medicine to plastic surgery to pediatrics (etc.), there are fewer patients in hospital per doctor.

In family practice, the volume of hospitalized patients has dropped significantly. Those patients that are admitted tend to be complicated and more time consuming. I don’t see family physicians as having abdicated their responsibilities by not attending a reduced number of hospitalized patients; I see them as using their time more efficiently. The hospitalist program has thus grown out of continent-wide changes in health care. It has also come about because it is good, both for the patients who get on-site care and for the financial health of the regions as patients move through the hospital more quickly. It is a program whose time has come.

—John R. McLeod, MD

John R. McLeod, MD. Re: The hospitalist program. BCMJ, Vol. 46, No. 3, April, 2004, Page(s) 113 - Letters.

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