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The Rise of the Hospitalist
According to a recent article in The New England Journal of Medicine, primary care medicine in the United States is
“at grave risk” of collapsing. Since primary care providers typically serve as a patient’s first point of contact in the
health care system, their importance cannot be overstated. However, in 2007, a 1 trivial 5.1percent of graduating
medical students had decided to pursue further training in this field.
2 One of the most promising solutions to our country’s primary care predicament is the evolution of the
“hospitalist.”First coined in 1996, the term “hospitalist” refers to physicians who dedicate most of 3 there career to the
care of acutely ill hospitalized patients. They provide care for patients who require hospital treatment with medicine
(rather than surgery). The vast majority of hospitalists are trained in internal medicine or family medicine, though a
small percentage also comes from other specialties including pediatrics, psychiatry, and dermatology.
4 Because hospitalists generally work twelve-hour shifts for seven days in a row, they provide patients with continuity
of care, allowing them to be seen by the same physician for much of their hospital stay. Since they are based in
the 5 hospital hospitalists can also check-up on each patient multiple times a day, and they can coordinate care from
specialists and ancillary departments such as 6 the physical and occupational therapy department, and the social
services department, and the nursing care management department. From the hospital’s perspective, hospitalists
are also generally associated with modest cost savings since hospitalists coordinate among multiple departments
and, as a result, 7 being well-positioned to effectively allocate hospital resources.
The rapid growth of hospitalist medicine in recent years suggests that hospitalists are here to stay. 8 While many
healthcare providers and recipients laud this growth, there are still a number of outstanding issues that need to be
addressed. For example, experts still do not know what long-term impacts the hospitalist movement will have on the
general internist and family medicine 9 workforce? If more internists and family medicine doctors decide to become hospitalists, what will happen to the availability of these doctors for the outpatient population? 10 In addition, if
hospitalists are to become full members of academic medical centers, they will likely need to incorporate a number of
additional skills into their training, particularly research skills.
While the precise trajectory of the hospitalist movement is still unclear, this new field of medicine has immense
potential to fill many of the current gaps in our healthcare system. 11
1 Which choice is most consistent with the first sentence of the passage?
A. NO CHANGE
B. minor
C. meager
D. limited
2 Which choice provides the smoothest transition between the first and second paragraphs?
A. NO CHANGE
B. Many medical students do not wish to pursue primary care because of the unreasonable work hours.
C. In the 1980s, the number of primary care physicians in the United States plummeted.
D. DELETE the underlined portion.
3
A. NO CHANGE
B. their
C. his or her
D. they're
4 Which choice most effectively establishes the main topic of the paragraph?
A. The growth of hospitalist medicine introduces a number of benefits for both patients and hospitals alike.
B. Hospitalists introduce a number of challenges for hospital patients and staff.
C. The growth of the hospitalist movement is likely to accelerate in the coming years.
D. Patients generally prefer hospitalists to other types of doctors due to the fact that hospitalists provide continuity
of care.
5
A. NO CHANGE
B. hospital,
C. hospital;
D. hospital:
6
A. NO CHANGE
B. physical and occupational therapy, social services, and nursing care management.
C. physical and occupational therapy, and social services, and also nursing care management.
D. the physical and occupational therapy department, and the social services department, and, in addition, the
nursing care management department.
7
A. NO CHANGE
B. which can be
C. are
D. DELETE the underlined portion.
8 At this point, the writer wants to add accurate and specific information from the graph to support the claim made in the previous sentence. Which choice best accomplishes this goal?
A. Since 2006, the hospitalist movement’s rate of growth has continued to increase.
B. Between 2006 and 2009, the number of hospitalists increased from nearly 20,000 to about 28,000.
C. In 2009, the number of hospitalists in the United States leveled off at around 30,000.
D. Between 2006 and 2009, the number of hospitalists in the United States more than doubled.
9
A. NO CHANGE
B. workforce;
C. workforce
D. workforce.
10 The writer is considering deleting the underlined sentence. Should the writer make this deletion?
A. Yes, because the sentence weakens the argument in favor of training more hospitalists.
B. Yes, because the sentence restates information provided earlier in the paragraph about the need for additional
training for hospitalists.
C. No, because the sentence provides another example of a future challenge for the hospitalist movement.
D. No, because the sentence provides another example of a benefit to patients for training more hospitalists.
11 The writer wants to conclude the passage by proposing a relevant question for the reader to consider. Which
choice best accomplishes this goal?
A. The question now is whether it would be worth the effort to train more hospitalists.
B. The question now is not whether to hire hospitalists, but how much to pay them.
C. The question now is whether training more hospitalists will really improve patients' quality of care.
D. The question now is not whether we should be training hospitalists in this country, but how.
CABAB BCBDC D
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