The new era of hospital epidemiology: what you need to succeed. Clin. Infect. Dis

Managed care and competition are creating pressures to control costs and prevent adverse out-comes in health care. These forces are also creating a new era in hospital epidemiology, one in which there are many opportunities for the infectious disease physician. The ability to create and administer a hospital epidemiology program is a valuable asset in this environment. Included in hospital epidemiology programs are activities such as infection control, quality management, em-ployee health, risk management, and microbiology and clinical pharmacy consultations. The hospital epidemiologist must be prepared to take advantage of the opportunities created. Managed care and health maintenance organizations are in-creasingly prevalent options for providing health care. These organizations depend upon "gatekeepers, " usually primary care physicians, to manage the care ofmost patients. Specialists are used less frequently in managed care than in fee-for-service medicine. However, the infectious disease specialist possesses unique skills that may be helpful to managed care organizations [1]. Among the most useful skills is the ability to manage