The use of the hospitalist is a means to increase the efficiency of hospitals by achieving equal or better outcomes of care while reducing the cost of care. I comment on David Meltzer's controlled study of the costs and outcomes of hospitalist care, which showed increased cost savings and no change in patients' satisfaction with their care. Relative to full-time community practice, Meltzer's findings probably exaggerate the effect of hospitalists on costs. The physicians in charge of the control group of patients were full-time academic faculty, who typically spend 1 or 2 months per year doing inpatient care, in contrast to hospitalists, who spent most of their time caring for hospitalized patients. His findings probably minimize differences in satisfaction with care. Resident physicians did most of the bedside care for the hospitalist patients and the control group patients, an arrangement that would reduce any intrinsic differences.