Academic Hospitalists and Health Care Costs

We read with great interest the Commentary by Dalen et al1 in the November 2018 issue of The American Journal of Medicine examining the relationships among hospitalists, medical education, and health care costs. The authors correctly point out the seismic shifts that have occurred over the past 20 years in the care of inpatients and in the education of medical residents. Hospitalists have now become the dominant attending physicians for inpatients and, by default, the primary instructors for an entire generation of residents in internal medicine, family medicine, neurology, and other disciplines.