Interim analyses will be performed 6 months after hospitalists become responsible for the 2nd and 3rd services to verify that the hospitalist program does not unexpectedly worsen outcome or increase costs before expanding the program to all 4 services. Otherwise the study will continue as planned with final analyses performed on all patients admitted by 6 months after the hospitalists assume responsibility for the 4th and final service. The investigators will conclude that hospitalist program is cost effective if Bayesian analyses indicate a 90% or higher probability that it reduces hospital days and/or reduces costs.