To the Editor:

“Seven Ways to Help Your Hospital Stay in Business” was right on target. I’d like to suggest an additional strategy: the family physician must act as the “captain of the ship.” As a family physician and medical director of a community hospital, I have seen too many delays in care and discharge that resulted from a physician abdicating his or her role to the subspecialists. At our facility, some patients admitted for chest pain and ruled out for cardiac disease have remained in the hospital for three additional days while the subspecialists performed everything from CT scans to endoscopies. I suggest developing care maps or guidelines that start in the ED and assist the physician in the most expeditious work-up of his or her patients.