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, since generalists have perennially been undervalued by health care institutions, payers, and even patients.13 The greater prominence of generalism has led to an increase in the number of medical students who choose careers in primary care,4 expanded job opportunities for generalists,5 and a modest increase in the incomes of primary care physicians.6 Two of the principles underlying generalism, whether in the form of internal medicine, pediatrics, . . .