Medicolegal Issues

Promote the Generalists


Isn’t it ironic that just as America is waking up to the importance of primary care medicine, our own representative organizations are selling us down the river?

The training of primary care physicians has for decades allowed us to branch out and follow our patients in multiple sites of care. We are the masters of managing care across this continuum.

Government and big business are finally recognizing that they need to bolster primary care to manage patients in the new chronic care medical home models. They are finally recognizing the need to better supply, equip, and finance primary care physicians.

The American College of Physicians (ACP), the American Academy of Family Practice (AAFP), and the American Medical Association all appear to support this concept. So where is the irony?

The American Board of Internal Medicine (ABIM), along with the aforementioned groups and others, continues to carve medicine into ever increasing sub areas, based on sites of care and interests. Hospitalists (who already have three branches—general hospitalists, proceduralists, and nocturnists) are seeking special certification recognition through ABIM. Palliative care is a new certification. These branches of medicine deserve recognition, but do we need all these fractured certifications?

Soon, no primary care physicians will be certified as capable of practicing in multiple sites of care without multiple certifications for each separate site and individual function. Soon there will be no “general” primary care physicians. Can hospitalists equally manage the whole continuum of care, or will they need to become generalists again to do the job?

Medicine teaches us to care for the whole person—body, mind, and spirit—not just individual parts. I urge the ABIM, the ACP, the AAFP, the AMA, SHM, and others to stop this fracturing of primary care. Now is the time to promote the generalists. Now is the time to lift all primary care-related areas of medicine together, leaving no one behind.

John M. Colombo, MD


Crozer Keystone Health Network


No doubt you’ve noticed a few things are different with this edition of your official SHM publication. Thanks to your feedback, we’ve instituted new features and retooled the design to make The Hospitalist more useful to you. A quick look at the changes made with you in mind:


Back by popular demand are “The Hospital Pharmacy” and “JHM Sneak Peek.” The pharmacy department will give you insight into the drugs you need to know, as well as the lowdown on what’s on and off the market and what new warnings to be aware of. Then, we’ll give you an exclusive look behind the research featured in the current issue of the Journal of Hospital Medicine.

And, if you have a hospital medicine question and don’t know whom to ask—then e-mail Dr. Hospitalist ([email protected]), our new advice columnist, who will respond to your queries every month.


Columns, departments, and features have been reorganized to make related content easier to find. First to appear in each issue is “SHM Society Pages.” Next is the “Clinical” section, where we’ve gathered reader favorites “In the Literature,” “Hospital Pharmacy,” and “JHM Sneak Peek.” After that you’ll find the “Career” pages, including “Public Policy.”

At the back of each issue, we’ll bring together some of the leading voices of SHM, including John Nelson and his “Practice Management” column, Jeff Glasheen’s “From the Editor’s Desk,” Larry Wellikson’s “SHM Point of View,” Rusty Holman’s “President’s Column,” and “Dr. Hospitalist.”


We’ve streamlined our typography and color coded each section to help you navigate through each edition. “SHM Society Pages” is in the dark blue section, “Clinical” coverage in the green section, “Career” coverage in the red section, and “Personalities” in the light blue section.

Headlines are bigger, and section labels and page numbers have been refined. More information is broken out into easy-to-read boxes, and these boxes are often anchored so they’ll appear in the same spot with your favorite features.

We hope you enjoy the new look of The Hospitalist. TH

Geoffrey Giordano


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