Most community hospitals in my metropolitan region have shifted from a 12- or 16-h workday to 24-h coverage. As Kerlin and Halpern1 mentioned, the benefits of this move seemingly have strong face validity and the support of observational studies. However, a significant consequence of this shift is that a small regional pool of community intensivists is now spread thin to cover nights. This, in turn, has led to lean and fractured day coverage and exacerbated a provider tug-of-war between facilities where full-time equivalent (FTE) and moonlighting physicians recruited to fill voids created by night staffing at one facility leave voids at another. For example, we recently recruited an FTE physician from one facility, leaving that facility, which had recently transitioned to 24-h coverage, more short staffed. A nearby hospital just transitioned to 24-h staffing and recruited one of our moonlighter physicians, necessitating our FTE physicians to work more nights. These voids are challenging to fill given the ongoing shortage of trained intensivists and may offset the purported benefits of 24-h coverage.