Traditionally, this has been the role of the primary care physician. However, among all the providers that paraded through this patient’s room, none was her primary care physician. Banished from the wards to achieve greater efficiencies and lower inpatient costs, the primary care physician is conspicuously absent from inpatient care. Hospitalists have been shown to effectively reduce inpatient lengths-of-stay. And the demands of an ever-increasing outpatient work load keep primary care physicians chained to their offices. While the efficiencies produced by this division of labor are well-documented, another silo has been created that further fragments patient care.