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EDITOR'S CHOICE: Fiona Godlee An uncomfortable ride BMJ 2005; 331: 0-f [Full text]

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Don't worry

Graeme M Mackenzie   (22 November 2005)

The writing on the wall

Patricio Herrera   (24 November 2005)

Don't worry 22 November 2005
Graeme M Mackenzie, gp Whitehaven CA28 7RG Send response to journal: Re: Don't worry	I counsel most GPs not to worry about competition. Firstly I have become a bit cynical and suspect government initiatives are meant to unsettle us so that we are weaker and a bit easier to deal with. Secondly having worked in three practices and met many GPs in my 20 years as a principal, I have found most of my colleagues hard working and dedicated, albeit in different ways. In my current practice we provide unparalleled access to primary care services, backed up (and this is most important) by a comprehensive medical record that has been built up by us and is one of the main reasons we can provide efficient and effective care at I suspect much lower cost than the private sector. Of course, life is not fair and the non monetary (time mainly) and monetary investment GPs have put into current excellent services will perhaps not be rewarded as the private sector seeks to exploit our hard work, mainly by accessing the record WE have built up and used to benefit patients. And of course we know that that the private sector may be funded up to the point it succeeds: proving nothing of course other than that the playing field is not level. Bring on the private sector because in a straight fight I suspect most GPs would not have to break sweat to see them off. However, as I said, life is not fair, so perhaps we should worry after all. Competing interests: None declared
The writing on the wall 24 November 2005
Patricio Herrera, pediatrician Roberto del Rio Children's Hospital, Profesor Zañartu 1085, Santiago, Chile Send response to journal: Re: The writing on the wall	Chilean doctors were unable to read “the writing on the wall”, even though it appeared long before the market health “revolution” destroyed the successful previous Chilean NHS. After the rampant economic tsunami, people were still unable to read and understand the message addressed by the writing to them: the collapse of the doctor/patient unit, the unique basis for what may be understood as “humaneness”. Past “patients” are currently “clients”, something that summarises the dead relationship. Competing interests: None declared