The Korean hospitalist system was introduced in 2016. The new inpatient care system that provides direct care from a specialist required great efforts from various parties to implement successfully. This study outlines the implementation of the Korean hospitalist system and the development strategies based on pilot studies. The definition of the Korean hospitalist includes two elements which are 1) hospitalist is a physician who is in charge of a patient from admission to discharge and 2) hospitalist should stay in the hospitalist ward, where a hospitalist provides medical services to patients at their point of needs. The purpose of the Korean hospitalist system is to provide high-quality care and to ensure the safety of admitted patients. Due to a gap in the healthcare workforces in hospitals caused by changes in the residents' working hours and training period of the residents, the implementation of a new system was inevitable to provide care for patients. The result of private and public pilot studies indicated that hospitals, physicians, and patients are keen to have the hospitalist system in place. Also, those stakeholders agreed that reasonable and accurate fee-schedules for hospitalist services would enhance the service system. Within the current system, hospitals are reimbursed for providing the service, while patients pay out-of-pocket. Therefore, the service can only be applied to a patient who agrees to pay the additional fee for the service. As the Korean medical system is facing a paradigm shift, the Korean hospitalist system will play an essential role in the transition as moving forward to provide professional care for inpatients.