In response to an on-line article entitled "Hospitalists and the Decline of Comprehensive Care",  by Richard Gunderman, MD, Ph.D., published on 08/10/16 by the New England Journal of Medicine; we offer the following: 

The emergence of hospitalist medicine is attributable to the (1) growing complexity of operating a private practice (2) growing complexity of maintaining hospital privileges and related requirements and finally the (3) influence of millennials. Operating a private primary care practice, and meeting hospital medical staff particpation requirements, is exponentially more complicated than even a few years ago. EMR proficiency, Meaningful Use, HIPAA, and HITECH requirements/regulations did not exist 20 years ago.

Primary care physicians have found it incredibly challenging to master both an outpatient practice and a hospital practice. And millennials are not willing to fall prey to the work-life imbalance of the previous generation.

Hospitals did not invent and promulgate the hospitalist specialty - rather most discovered in recent years they must offer a stable hospitalist service or lose the opportunity to recruit many new primary care physicians (and even some specialists). The medical community must embrace the reality of the hospitalist phenomenon, and then address the imperfections. It is here to stay, in our opinion.