Tuesday, May 27, 2008

Will the options for internists be even fewer as time goes by?

Had retirement not worked out to be better than I had hoped for, I had thought that a concierge practice or being a hospitalist would be the way for me to go. The retainer practice might allow me to escape from the clutches of the third party payers whose ever tightening of the control and payments screws sucked much of the joy of patient care and the threat of things getting even worse casting a pale over the future. The hospitalist gig offered the relief of no call and a opportunity to attend the type of complex,often very ill patients which seemed to be what an internist was trained to do.

But now we hear that perhaps the hospitalist role may not be a safe haven for the internist for very long. Dr. RW tells us about that scenario here.

Even as the future for hospitalist might appear less rosy, we should not forget that the safety and quality movement leader guru, Dr. Donald Berwick still has much for them to do as they become the change agents and integrators of a new medical system that will provide quality care, reduce costs and improve public health. I guess it is better that I did not become a hospitalist as all I could do on a good day was to take as good of care of my patients as I could leaving the problems of maximizing public health and obtaining universal medical coverage to someone else.

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