Elsewhere in this issue (p 154), A. H. Khazei and his associates report on the feasibility of open heart surgery in the community hospital. Their concise article describes an effective program with excellent clinical results. Regional and community development of special facilities, such as those required for the conduct of open heart surgery, are important if highly technical modes of therapy are to be made available within reasonable geographic proximity to the serviced population. The development of such facilities in the community hospital requires, first, recognition of a need for such services based on community size. Duplication of similar facilities by multiple hospitals within the community, yet beyond the requirements of the serviced population, can only serve to dilute the programs and personnel involved, and magnify total costs in space, equipment, and training. Avoidance of such duplication can be achieved only if cooperative regional or community planning precludes such development.