Hospital healthcare is essentially teamwork. Frequently, however, one comes across incidents where inter-departmental cooperation is compromised. It can create an awkward situation for residents and other staff members involved in the healthcare system. We can recall many such incidents during our training. Studies have indicated that failure in "tightly coupled" organisational relationships between hospital departments imposes a threat to patient safety. Clear guidelines on how to manage certain situations should be in place, leaving no ambiguity as far as issues concerning patient management are concerned. A lot more needs to be done by administrators to avoid such incidents and to promote inter-departmental co-operation. In addition, more caution and effort by administrators, residents and faculty can help avoid such incidents.