Medicine And Books

Managing Scarcity: Priority Setting and Rationing in the National Health Service

BMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7076.313 (Published 25 January 1997) Cite this as: BMJ 1997;314:313
  1. Iona Heath, general practitioner
  1. Caversham Group Practice, London and member of Rationing Agenda Group

    Rudolf Klein, Patricia Day, Sharon Redmayne /Open University Press, £13.99, pp 161/ISBN 0 335 19446 X

    How should individual doctors rank the needs of the different patients they encounter? In daily practice my endeavours feel very imprecise. I attempt to allocate my time roughly in proportion to the level of patients' distress and the complexity of their problem. If there is too much to do, I ration, mostly by dilution–I spread myself a little thinner, giving a little less to everyone but probably in much the same proportions. I strive not to close the door completely on anyone because to do so is to belittle their distress and their fear.

    At least …

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