Renaissance of hospital generalists

  title={Renaissance of hospital generalists},
  author={Robert M. Wachter and Derek Bell},
  journal={BMJ : British Medical Journal},
Hospital medicine in the US and acute medicine in the UK are the fastest growing specialties in their countries. Robert M Wachter and Derek Bell examine the factors behind their rise and how the differing national healthcare systems have influenced their structure 

Should every adult patient in the hospital have an internist?

Hospital medicine is a new venue for practicing internal medicine that provides continuous care throughout the hospitalization period and even beyond.

Inpatient care: should the general physician now take charge?

In an ageing population, patients are living longer with one or more chronic disease, and with acute illnesses increasingly extending outside the boundaries of a single medical specialty. Therefore,

Must be trained in geriatric medicine

It is important to focus on how we deliver the most acute stages of hospital care when acute medical admissions are likely to comprise older patients with multimorbidity, frailty, and polypharmacy.1

Lessons from across the Atlantic: an overview of hospitalist medicine in the USA

  • T. Khan
  • Medicine
    Future Healthcare Journal
  • 2017
This article explores the model at Rush University Medical Center in Chicago and any lessons the UK could learn from them about generalist inpatient medical care.

What is the role of general internists in the tertiary or academic setting?

Is it time for a new kind of hospital physician?

The changing demography requires current models of inpatient care to evolve to keep pace with the changing demographics.

An Acute Medical Unit in a Korean Tertiary Care Hospital Reduces the Length of Stay and Waiting Time in the Emergency Department

A hospitalist-run acute medical unit (AMU) opened at a tertiary care hospital on August 2015 for the first time in Korea and the median length of stay significantly decreased; the median waiting time in the ED significantly shortened; and future studies on the impact of AMU on in-patient morbidity, mortality, re-admission rate, and patient or staff satisfaction are necessary.

The changing face of internal medicine: patient centred care.

Improving the quality of care for medical inpatients by placing a higher priority on ward rounds.

Improved quality of care, better assured patients and relatives, and better consultant job satisfaction are shown, but also showed reduced junior doctors' independent decision-making and a slight reduction in specialty-related activity.

Relationship based care – how general practice developed and why it is undermined within contemporary healthcare systems

  • C. Rudebeck
  • Medicine, Political Science
    Scandinavian journal of primary health care
  • 2019
Investigating the state of generalism in medicine from the outlook of general practice finds that when the disease rather than the doctor-patient relationship becomes the organising principle of primary care, medicine as a whole will be drained of the practice of its human dimension.



A guide to the acute medical unit.

This map shows how acute medical units, which provide the best possible care for acutely unwell medical patients, are increasingly common in the UK.

Acute medicine: making it work for patients.

The report of a working party of the Royal College of Physicians, Acute Medicine: making it work for patients, seeks to improve hospital care of patients who are acutely ill and highlights the

Acute medical units: review of evidence.

  • D. ByrneB. Silke
  • Medicine, Political Science
    European journal of internal medicine
  • 2011

The emerging role of "hospitalists" in the American health care system.

The explosive growth of managed care has led to an increased role for general internists and other primary care physicians in the American health care system. This change is welcome in many respects,

Growth in the care of older patients by hospitalists in the United States.

These analyses of data from Medicare claims showed a substantial increase in the care of hospitalized patients by hospitalist physicians from 1995 to 2006, with marked geographic variation in the rates of care provided by hospitalists.

Effectiveness of acute medical units in hospitals: a systematic review.

  • I. ScottL. VaughanD. Bell
  • Medicine
    International journal for quality in health care : journal of the International Society for Quality in Health Care
  • 2009
Limited observational data suggest AMUs reduce in-patient mortality, length of stay and emergency department access block without increasing readmission rates, and improve patient and staff satisfaction.

The hospitalist movement 5 years later.

Empirical research supports the premise that hospitalists improve inpatient efficiency without harmful effects on quality or patient satisfaction, and analyzes the impact of hospitalists on the health care system and frame key issues facing the movement.

Do subspecialists working outside of their specialty provide less efficient and lower-quality care to hospitalized patients than do primary care physicians?

Patients cared for by subspecialists practicing outside of their subspecialty had longer lengths of stay, and prolongations of stay were observed for patients with congestive heart failure, upper gastrointestinal hemorrhage, and community-acquired pneumonia than patients care for by general internists.