Hospital medicine is the fastest growing medical specialtyin the United States. Time pressures on primary-care physicians in the office and cost pressures on hospitals are the main driving forces behind this movement. Despite initial criticism and skepticism, hospitalist programs have proven cost effective in clinical and academic departments of internal medicine. These programs have recently been used in medical subspecialty departments as well. Hartford Hospital adopted a new specialty hospitalist program in its cardiovascular department. This program grew to become one of the most successful hospitalist programs in the hospital. Since better quality of care at a lower cost is the ultimate goal for any proposed health-care innovation, we predict that similar subspecialty hospitalist programs will become an accepted part of future hospital care. This article discusses specialty hospitalist care and describes our development of such a program at Hartford Hospital.