, Volume 23, Issue 8, pp 1288-1289,
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Where Should Hospitalist Programs be Housed?

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Flanders and colleagues have written an important opinion piece that helps advance the critical dialogue regarding the future organization of academic divisions of general internal medicine (ADGIM).1 The authors give a balanced view of the current state of ADGIM and some of the challenges now faced as hospitalist programs rapidly grow. According to Flanders, the demand for hospitalists continues to grow for all hospital types. Several pressures have fueled this rapid growth: shrinking profit margins in the health industry, hospitals’ financial need to decrease LOS, increasing quality measures imposed by the federal government and insurers, and the recent development of work-duty regulations, which have stimulated teaching hospitals to create non-housestaff inpatient coverage. The latter factor has pushed academic medical centers to rapidly hire hospitalists, both for patient care and education.

It is important to understand the focus of the discussion and to appreciate that the definiti