Re: Renaissance of hospital generalists
Wachter and Bell touch on the very essence of why the "generalist" or acute physician is so important to modern day medicine. As the European Working Time Directive (EWTD) has limited the number of hours doctors can work within a week, along with the increasing number of rota gaps, their role appears to have become pivotal to many acute takes.
As a junior doctor who has been working on the hospital registrar rota since gaining my MRCP UK), I have found working with these acute physicians both supportive as I make my step on the reg rota, but also highly educational in managing acutely unwell patients, as well as making that judgement call on who to send home, who to observe and who do admit. In our hospital the acute physician also runs daily headache clinics, a Medical Day Unit review clinic, and DVT and PE clinics. These combined have drastically reduced the number of admissions and referrals via A+E, have freed up beds and most importantly kept relatively well patients out of the dangerous in-patient environment. The opportunities for juniors to work on call on the unit also allows a calmer, controlled environment for teaching and reflection.