The quality of medical care delivered by physicians of different specialties has been the subject of debate for some time. Studies have suffered from a variety of flaws. This study used the MedisGroups comparative database to compare outcome measures in hospitalized patients aged 65 years and older treated either by the family physicians or internists as attending physicians. Using the 10 most common diagnostic related groups for internal medicine, 10,353 admissions to internists were compared with 5,473 admissions to family physicians. Patients admitted by family physicians had a significantly higher admission illness severity and were significantly older. There was no significant difference in morbidity and mortality. The lower average charges for patients admitted to family physicians were statistically significant.