Hospitalists actually improve quality of care for inpatients. Length of stay is more appropriate. Patients don't have to wait for the internist to get done with patients in the office before their concerns are addressed. Your average internist who primarily sees outpatients is not going to be as well versed and familiar with hospital care as a hospitalist and vice versa. Overall it leads to better care for the patient. Night float was actually a wonderful time to learn about patients and disease processes b/c you saw the chronic patients every night, dealt with problems that came up unemcumbered by having to write orders for this specialist, updating families, setting up social services or nursing home care, and all the other scut work that keeps you from actually thinking and learning about the patient.