Reflections: The hospitalist movement a decade later


  • Robert M. Wachter MD

    Corresponding author
    1. Professor and Associate Chairman, Department of Medicine, University of California, San Francisco, and Chief of the Medical Service, UCSF Medical Center, San Francisco, California
    • Box 0120, UCSF, 505 Parnassus, San Francisco, CA 94143-0120; Fax: (415) 502-5869
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  • I am grateful to Win Whitcomb and John Nelson for their friendship and inspiration, and for reviewing the manuscript, which helped to compensate for my faltering memory.


August 2006 marks the 10th anniversary of the publication of an article in the New England Journal of Medicine in which Lee Goldman and I coined the term hospitalist—an event that many people characterize as the start of the hospitalist movement in the United States. The present article describes the history of those early days, highlighting some of the choices the field's initial leaders made to nurture the new specialty. In retrospect, although there were many examples of fortunate serendipity, there were also several key strategic choices, including the focus on gathering research data to demonstrate the value of the field to external stakeholders; the forceful rejection of mandatory hospitalist systems, particularly those promoted by managed care organizations; and the purposeful linking of our new field to the burgeoning movements to improve quality and patient safety in hospitals. Most of all, the field's spectacular growth and successes can be attributed to the daily work of thousands of hospitalists in clinical care, education, research, and systems improvement. These individuals have given life to our theoretical notion a decade ago that a new model for inpatient care would improve the American health care system and the care of inpatients. Journal of Hospital Medicine 2006;1:248–252. © 2006 Society of Hospital Medicine.