Objective: We sought to create a novel physician assistant (PA) and physician hospital medicine co-management strategy, employing a 3:1 PA:physician structure, under which the physician oversees all PA patients, but without a separate independent panel. Methods: This is a retrospective cohort pre-post design, comparing metrics for a traditional physician-only hospitalist model with a PA-physician team model. Outcomes included length of stay (LOS), readmissions, discharge destination, patient satisfaction, and in-hospital mortality. Results: LOS for patients under the PA-physician model (74 hours) was lower than for the physician-only model (83 hours; P < .001). The PA-physician model team discharged more patients home than to another facility (PA-physician 77.6%, physician-only 74.3%; P = .03). Thirty-day readmissions were about 10% (P = .97) and patients reported respectful treatment in about 80% (P = .53) of cases in each cohort. Conclusions: Our 3:1 PA-physician model team showed equal to superior outcomes compared with the physician-only hospitalist model.