Published online February 1, 2007
PEDIATRICS Vol. 119 No. 2 February 2007, pp. 412-413 (doi:10.1542/peds.2006-3234)
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LETTER TO THE EDITOR

Residency Faculty as Hospitalists: In Reply

Kristen Samaddar, MD
John Boyd, III, MD, MBA
Lilia Parra-Roide, MD
Edith Prieto Allen, MD
Bruce White, DO, JD
Division of Pediatrics
St Joseph's Hospital and Medical Center
Phoenix, AZ 85013

We appreciate Dr Smith's remarks pertaining to our recent article comparing pediatric faculty and hospitalists in a community teaching hospital. It seems that we have reached similar conclusions after studying various models for caring for patients in urban community hospitals. In pediatrics, this type of hospital setting has been poorly represented in the hospitalist literature.

Many factors affect patients' length of stay and hospital costs. In both of our studies, continuity of care with patients was an important factor. The faculty physicians in our study had continuity of care with patients from the residents' teaching clinic, but these patients represented only a portion of the patients for whom they cared. Unfortunately, this was not a measured portion. Continuity of care with the residents is another significant factor that we believe contributes to efficiency in care. At the time of our study, the faculty worked very closely with the residents on rounds and during didactic sessions. The hospitalists' relationship with the residents was not as interactive. Subsequent to the study, all attending groups in the study have scheduled time to discuss patient care with the residents.

Many studies have demonstrated greater efficiency for hospitalist groups compared with other models. However, as demonstrated by our studies, hospitalists may not be superior in all settings. We should continue to study the efficiency and quality of inpatient care for different models of practice before replacing all models with hospitalists.

PEDIATRICS (ISSN 1098-4275). ©2007 by the American Academy of Pediatrics




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