The names, specialties, and appointment status of physicians with privileges in 161 North Carolina hospitals were obtained and compared to the file of licensed, active, patient-care physicians practicing in the State for the year 1978. The listings were examined to determine the number of physicians without a hospital privilege by age, race, sex, specialty, and geographic location. Overall, only 11 percent of all active physicians did not have some form of hospital appointment. Among family and general practitioners, 29 percent had either a restricted hospital privilege or no hospital appointment at all. A greater number of nonwhite and female physicians were also without privileges. These data have implications for the training of physicians in a system that emphasizes hospital care and includes inpatient treatment within the purview of primary care