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The Hospitalist Movement in the United States |


Robert M. Wachter, MD
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University of California, San Francisco; San Francisco, CA 94143

Ann Intern Med. 1999;130(4_Part_2):337. doi:10.7326/0003-4819-130-4-199902160-00012
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During the 20th century, the U.S. hospital has been the site of breathtaking technological progress and equally remarkable variation and iatrogenesis. Even as our profession has turned its attention to the outpatient world in which the majority of our patients reside, we neglect the hospital at our peril. Most of us entered this world inside its walls, and most of us will leave it there. And in this era in which U.S. health care is finally being forced to confront the immutable economic laws of nature, the hospital continues to be the place where we spend about one third of our health care dollars, an amount equivalent to 5% of our nation's gross national product. By any accounting, what happens there matters.

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