Even within general pediatrics, there has been a potential further fragmentation by site of care. Perhaps as a form of subspecialization, the hospitalist movement has grown steadily. This too has had and will continue to impact the health care delivery system. The term hospitalist was initially coined in 1996 by Wachter and Goldman.13 The number and demand for hospitalists has been increasing. A survey by the Society for Hospitalist Medicine found that in the last 2 years, there has been a 31% increase in the number of hospitalist groups.14 The impact of hospitalists on health care delivery has steadily evolved, thanks to evidence that suggests that hospitalists can improve efficiency and quality of care through their expertise. Hospitalists function both as inpatient generalists and in subspecialty settings—for example, on a cardiology or oncology inpatient unit. To this point, most have had core residency training in general pediatrics, some in the few existing hospitalist fellowship programs; and others have elected hospital-based practice after subspecialty training.The hospitalist movement adds new challenges to the health care delivery system.15, 16 It creates another point of potential fragmentation of care as a single hospitalist may not stay with an individual patient and family throughout their hospital stay. It is another place where there may be disconnect between the primary care provider and the hospital based provider. Yet on the positive side, hospitalist care may be more efficient and focused on the systems within the hospital and the quality and safety of care. The training of pediatric residents often prepares them for a hospitalist career, and the career is appealing to many because of the flexibility and control of work hours which appear to be important factors in the recent trends in specialty choice of medical students.17