To the Editor:

While it is in society’s best interest to keep hospitals solvent as suggested in “Seven Ways to Help Your Hospital Stay in Business” [May 2003, page 27], our primary obligation as physicians is to the patient we are treating at the moment. We are already expected to manage their finances by finding the cheapest drugs, the cheapest tests, etc., and to manage their insurance by knowing what is covered, who is covered and how to advocate when claims are denied. Given these ever-increasing responsibilities, we may not want to change how we manage their hospital care. It will cost a patient with chest pain the same amount to be admitted overnight to rule out MI as it would to stay two days and have a cardiac catheterization. Let’s face it, the system is broken.