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Can Fam Physician
Vol. 53, No. 12, December 2007, p.2131
Copyright © 2007 by The College of Family Physicians of Canada
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Clinical Review

Les implications du phénomène des médecins hospitaliers

François Lehmann, MD, Yvon Brunelle, Martin Dawes, MD, Richard Boulé, MD and Rénald Bergeron, MD
Au moment de la rédaction, Drs Lehmann, Dawes, Boulé et Bergeron étaient chefs des départements de la médecine familiale à l’Université de Montréal, à l’Université McGill, à l’Université de Sherbrooke et à l’Université Laval, respectivement. Monsieur Brunelle est agent de recherche au ministère de la Santé et des Services sociaux du Québec

Correspondance à: Dr François Lehmann, Département de médecine familiale, Faculté de médecine, Université de Montréal, CP 6128, Succursale Centre-Ville, Montréal, QC H3C 3J7; téléphone 514 343-6497; télécopieur 514 343-2258; courriel francois.lehmann{at}umontreal.ca

OBJECTIVE To evaluate the effect of 2 different systems of hospital care by means of a literature review.

QUALITY OF EVIDENCE Many areas remain unclear because several of the studies are opportunistic and report only isolated experiences or simple before-after observations. Few studies are really experimental, and all were conducted in academic settings, which limits their validity outside these settings.

MAIN MESSAGE The evidence supports the use of hospitalists who devote a minimum of 2 months each year to hospital work and practice full-time on the wards. More often than not, costs are reduced and better education for residents is provided with the hospitalist system. An important point regarding quality of care is that mortality rates are similar with both systems.

CONCLUSION Some questions remain unanswered. For example, what is the best type of training for preparing residents for hospital work and what is the best way for physicians to maintain their skills in this area?






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