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By rethinking conventional care-delivery limits, hospitalists can strengthen evidence-based practice, improve outcomes, and reinforce public health in a more uncertain 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Dapaah-Afriyie, MD, MBA1,2  \n1 Division of Hospital Medicine, Department of Medicine, Miriam Hospital,  \n2 Department of Medicine, Brown University  \nJournal of Brown Hospital Medicine Vol. 5, Issue 1, 2025  \nArticle Information  \nKeywords: vaccination, immunization, hospitalist, hospital medicine  \n[https://doi.org/10.56305/001c.154706](https://doi.org/10.56305/001c.154706)  \nSubmitted: December 02, 2025 EST  \nAccepted: January 01, 2026 EST  \nPublished: December 19, 2025 EST  \nAbstract  \nRecent changes in healthcare policy, public health priorities, and the spread of misinformation have made it more difficult for hospitalists to secure timely outpatient follow-up after discharge. At the same time, evolving vaccination mandates and insurance coverage gaps have heightened risks to both individual patients and the broader community. By rethinking conventional limits of care delivery, hospitalistscan enhance patient outcomes, reinforce public health, and uphold evidence-based practice in an increasingly uncertain environment.  \nFor decades, the distinction between inpatient and outpatient care has served healthcare well, promoting appropriate utilization of resources and supporting efficient patient flow. Hospitalists have long depended on timely access to outpatient services to ensure safe discharges and sustained throughput across health systems. Yet the past year has tested these assumptions and strained the delicate balance between care settings.  \nThis has been an especially challenging period for the healthcare community. Disturbingly, disinformation and misinformation have gained traction not only among the public but also within the corridors of power. In Washington, D.C., unwarranted policy decisions and initiatives, often untethered from scientific evidence, have threatened the integrity and future of evidence-based medicine. In response, several professional organizations have taken unprecedented, collaborative steps to mitigate the potential harm of these actions and to defend the standards that underpin our profession.1  \nAt the same time, hospitalists face growing challenges in securing timely outpatient care for patients discharged from inpatient settings. Shifts in the public health landscape have compounded these difficulties. Changes in vaccination requirements and in what insurance plans will cover now pose new risks. For years, emergency department physicians have routinely administered tetanus boosters to patients with soft-tissue injuries. In the current environment, hospitalists must consider adopting similarly proactive measures to advance public health.2,3 Many institutions already offer influenza and pneumococcal vaccines to eligible inpatients, and during the COVID-19 pandemic, inpatient vaccination programs proved instrumental in improving community health  \noutcomes. These successes should encourage us to broaden our approach. As the incidence of metabolic dysfunction–associated steatotic liver disease and other chronic liver conditions continues to rise, inpatient initiation of hepatitis A and B vaccination in eligible patients warrants serious consideration. We can and should take additional steps to address the reported rise in severe localized and disseminated varicella zoster cases by offering shingles vaccination to eligible patients. Initiating these measures and implementing additional preventive interventions during hospitalization increase the likelihood of outpatient follow-up and completion of the vaccine series, thereby improving healthcare outcomes. The longstanding practice of deferring such critical preventive care exclusively to the outpatient setting deserves thoughtful reexamination.2,3  \nAs we look toward a new year, we should remain grateful for the privilege of guiding our patients through complex healthcare decisions amid considerable uncertainty. I am deeply appreciative of m","cbCaib2QrQuiYykV","https://ap.wps.com/l/cbCaib2QrQuiYykV","pdf",78465,"English","# Editorial\n## Challenge: discharge follow-up amid misinformation and policy shifts\n## Prevention: proactive inpatient vaccination to support outpatient completion\n## Outlook: professional commitment and safeguarding the mission","[{\"question\":\"Why do hospitalists face difficulty securing timely outpatient follow-up after discharge?\",\"answer\":\"Healthcare policy changes, shifting public health priorities, and the spread of misinformation make post-discharge coordination harder, while evolving vaccination mandates and insurance coverage gaps increase risk.\"},{\"question\":\"How does the editorial suggest hospitalists can advance public health?\",\"answer\":\"It recommends broadening preventive care by initiating eligible vaccinations during hospitalization and implementing additional preventive interventions to increase the likelihood of outpatient follow-up and completion of vaccine series.\"},{\"question\":\"Which proactive inpatient vaccine examples does the editorial highlight?\",\"answer\":\"It points to influenza and pneumococcal vaccines used in eligible inpatients, and urges consideration of hepatitis A and B vaccination for eligible patients as well as shingles vaccination for eligible patients to address reported varicella zoster cases.\"}]","Upholding Evidence, Advancing Prevention - The Evolving Mission of Hospital Medicine - editorial | PDF",1790621548]