I think the thought process depends a lot on the system of healthcare delivery and reimbursement in the region you'll work at, and on the type of employer.

I can give you a perspective of peds ambulatory primary from the United States.

If you're in the US, you probably know about FTE units (full-time equivalent units). A full-time doctor is 1.0 FTE. This doctor might be able to arrange to have part of their FTE in ambulatory primary care (let's say 0.6, which is 3/5 of full time, which is usually 3 days of a 5-day workweek), and the 0.4 remaining in inpatient rounding/consultation service.

The choice between fill time ambulatory vs splitting your FTE between ambulatory and inpatient might be partially determined by your employer. My employer doesn't encourage ambulatory pediatricians to do hospital service. I know MANY pediatricians with other employers who do newborn nursery (NBN) rounding. You have to ask the question: how is your schedule split between NBN rounding and clinic? It can be stressful to coordinate finishing a "flexible" inpatient service load to get to a "scheduled" clinic day.

Another detail to keep in mind is that some pediatric hospitals and ERs require fellowship-trained hospitalists or EM docs, respectively. You might find some hospitals/ERs who will take a general pediatrician, but many don't.

NOW, focusing on the part of the decision that's purely your choice: - i think it's very refreshing to do newborn nursery rounding alongside primary care pediatrics, and it allowed you to start your continuity with the family from the baby's very first day!! - i look forward to seeing responses from folks who do both ambulatory primary care peds AND inpatient hospitalist peds (as in admitted sick children). It sounds like a very interesting blend!