To those brave souls who have returned after digesting last week’s cheerleading on hospitalists, here is the Achilles’s heel of the system. While the advantages are clear and substantial, there are serious vulnerabilities which have not yet been adequately remedied. Achilles Held by the Heel Being Dipped into the River Styx Hospitalists cannot appreciate the medical nuances, personality, family dynamics, life events and prior experiences that may be well known by the out-patient physician. There are serious communication lapses, all of which cannot be bridged. The out-patient doc may know that the patient’s chest pain is his typical anxiety and that it is not necessary to repeat the cardiac evaluation that was done 2 years ago. The hospitalist may take a different tack here. Despite their best efforts, hospitalists know that they will not be seeing the patients after discharge. As they are not permanently vested, they may not address certain patient concerns, pu
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