I am glad you agree.
Rather than castigate hospital medicine should we not address ambulatory care
As structured today the trained internist despite superior skills is not looked upon,treated or reimbursed differently than other physician extenders who populate this arena.
Is it not natural for the trained Internist to gravitate to an environment of comfort ….the hospital?
Is ambulatory care really a challenge? “health maintenance ” interventions whatever their benefits can be ordered by a school boy with a protocol list.
The sick patient is shunted to the many specialists with the ambulatory practitioner doing the paper work to satisfy some paper pushing healthcare administrator.
There is a role for the general Internist.
In the United Kingdom they are called consultant physicians. They admit patients to the hospital and direct their care in that facility, If the patient has conditions needing their continued attention they are followed in the outpatient clinics run by these physicians. If not they are returned to their geneal practitioners.
This occurs because of the National Health System (a true public option) where the use of IT involves over 90 i% of all physicians.