Another problematic, though not unanticipated, consequence of the use of hospitalists has been a diminished role for specialists and researchers on teaching ser-vices. Because specialists are far less likely than they once were to serve as inpatient attendings, trainees have less contact with them and less exposure to basic and translational science

For house staff in internal medicine, the introduc-tion of hospitalists may mean a greater likelihood ofbeing supervised by attending physicians who arehighly skilled and experienced in providing inpatientcare. House staff have long enjoyed a certain amountof autonomy, because many of their faculty supervi-sors have been relatively unfamiliar with moderninpatient care. Such autonomy may be diminishedwith the new approach to inpatient care. Althoughthere is bound to be transitional pain, we believethat the potential for improved inpatient teachingwill more than compensate for it. Moreover, thischange will help answer public calls for closer andmore effective faculty oversight of house staff andstudents.34