It s a money-saving device, and not necessarily for the benefit of the patient. McVay argues that young hospitalists just out of their internship or residency often lack the experience and knowledge to effectively manage the sickest patients. But she said the disruption in continuity of care is the most troubling aspect. Proponents argue that the upside of the hospitalist model is the availability of the team and the efficiency of having bedside nurses coordinate care with a physician or NP, instead of tracking down a separate physician for each patient. Mitchell Wilson, MD, medical director of Community Inpatient Medicine Service at the University of Texas Medical Branch at Galveston, is considered the nation s expert on integrating nurse practitioners into existing systems.
Patients feel like they are getting more care.
The model can really optimize efficiency. Hospitalists are quick to dispute that the hospitalist model is a function of managed care, although they acknowledge HMOs usually favor hospitalists. Wachter said preliminary studies show a 15 percent reduction in hospital costs and length of stay where hospitalists are used. One of the most flawed reasons for criticizing the hospitalist model is that it is a provision of managed care, that it has spread like an evil virus. It has grown very healthily in places with no managed care influence.