In this article an overview is presented of the emergence of medical psychology in the care of somatically ill patients. The situation in the Netherlands can be considered as prototypical. For 60 years, clinical psychologists have been working in general, teaching and academic hospitals. Nowadays, they are an integrated nonmedical specialism working in the medical setting of hospitals in the Netherlands, and are a full-member of the medical board. This paper discusses several topics: the position of the general hospital in the health care system in the Netherlands, the emergence of medical psychology in Dutch hospitals, the role of the professional association of medical psychologists, and the characteristics of patients seen by clinical psychologists. Following the discussion about the situation of medical psychology in other countries, recommendations are formulated for the further development of medical psychology in the Netherlands as well as in other countries.Keywords Medical psychology Á General, teaching and academic hospitals Á Clinical care Á Education Medical psychology is an emerging discipline in general hospitals all over the world. There is wide variation in penetration of this profession in the hospitals, their place in the organization, the patients seen and the financing of their work. In this article, we describe the development of medical psychology over the last 60 years in the Netherlands. We investigate the state of the art, the recent and oncoming developments and challenges medical psychologists will face, and we formulate recommendations on how to enhance the development of this profession. We consider the situation in the Netherlands as an example of how medical psychology can be developed and implemented in clinical care. We hope to contribute to an internationally focused discussion about a more unified vision on the practice of medical psychology. In our vision there should be internationally accepted standards about organizing and financing psychological care in hospitals.