Emergency medicine and hospital medicine: a call for collaboration

Background: In the United States, emergency physicians and hospitalists are increasingly responsible for managing hospitalized patients. These specialists share a common practice space and similar shift work schedules. Together they govern decisions about use of the most expensive care setting in medicine--the hospital.

Discussion: Unfortunately, in most institutions there is little collaboration between emergency physicians and hospitalists, resulting in missed opportunities to improve the quality of care and reduce its cost. In this call to action, we challenge emergency physicians and hospitalists to work together to develop protocols for consistent, evidence-based, and expeditious care of patients admitted from the ED; to collaborate in the care of ED patients who can safely be discharged home; to pursue joint quality, hospital leadership, and cost-effectiveness projects; to work in partnership to assure adequate staffing of hospital-based specialists; and to cooperate in the professional, front-line assessment of clinically and fiscally driven policies aimed at assessing the appropriateness of hospital admissions and readmissions.

Summary: Hospital care is increasingly driven by emergency physicians and hospitalists. We envision a vital role for ongoing collaboration between them in achieving the goals of patient care, education, and quality and safety outcomes.