Over the last decade, there have been dramatic developments in hospital geriatric care. These improved practices have been supported by the development of quality indicators, which allow physicians and other health care professionals to monitor and measure targeted processes and outcomes of care. This new understanding of the clinical complexity and heterogeneity of the hospitalized elderly population should not be perceived as solely the purview of geriatricians. All physicians involved in the hospital care of elderly patients should strive to attain the knowledge and skills described in this article. As the Baby Boom generation approaches 65 years, physicians and those involved in their training must anticipate and prepare for the reality that many of their patients will be elderly. Special expertise will be needed to provide the highest level of hospital care for this population, especially considering the potential negative effects of hospitalization on older adults.