Hospitals are working hard to address the new healthcare demands in an era of declining reimbursements, aging facilities, a staggered economy and competition from a new cadre of for-profit providers. In addition, hospitals are experiencing physician shortages with a gap of 130,000 specialists and 60,000 primary care physicians by 2020. The growing level of chronic diseases will increase the demand for medical subspecialties like endocrinology, cardiology, sports medicine and geriatrics. Hospitals need an effective strategy to promote outpatient care that relieves the pressures on hospital services and addresses the key issues of geographical outreach, patient capacity, expanding clinical programming, technology and sustainability.