Medical services are the sheet anchor of most general hospitals. They are so closely related to all other departments that sharp lines cannot be drawn to delineate specific responsibilities. Policies and procedures should not only be available in writing but updated periodically. Consultations should be readily available and the organisational relationships with related specialties should be clearly understood. Therapeutic procedures must be only on written prescription of clinicians, consultants, and the audit committee must have clear and well-established criteria of professional care.