There are several reasons why many hospitalist programs in the United States began to use a dedicated admitter. Hospitalists rounding on 15-20 patients per day on the floors meet with families, case managers and social workers throughout the day.  We want Hospitalists to focus on their patients and not be taken away from discharging and caring for sick patients to admit new patients. Many clinicians claim that it not only improves hospitalist satisfaction by giving hospitalists time to focus on either admitting or rounding, but improves a hospital’s throughput and potentially reduces length of stay. The thought is that having a dedicated admitter in the Emergency Department allows the admitter to see patients quicker, admit the patients and get patients moving without bottlenecks.  However, bottlenecks do occur quit and patient satisfaction can as well especially when the admitologist is hit with 3-4 admissions at one time and they must focus on the sickest first and often this causes a delay in admission.  Some Groups have found that having an admitter in the ED reduces ER length of stay. This is all relative and is affected by a number of factors in the hospital.