Co-management of surgical patients refers to patient care in which the medicine physician daily assesses acute issues, addresses medical comorbidities, communicates with surgeons, and facilitates patient care transition from the acute care hospital setting. Co-management of surgical patients is fast becoming a common practice, particularly among orthopedic, cardiothoracic, and neurosurgical services. Co-management leads to lower cost per admission and shorter lengths of stay without altering patient satisfaction. Implementation of co-management requires champions, stakeholders, comprehensive service agreement, outcome measures, and patient selection.