Physicians used to all be at the hospital in the mornings, both primary care providers and specialists. This was a key time to establish and maintain collegial relationships. The rise of hospitalists means that primary care doctors are no longer at the hospital and seem to have become more isolated. This is also starting to happen to specialties that are adopting the “hospitalist” model. The concern is that this is leading to a less engaged medical staff and more physician burnout. We have tried other social activities but it is hard to replicate the daily interactions that used to occur in the hospital. I don’t think the hospitalist model is going away and will likely grow, how can we replace what has been lost in terms of staff interactions.