Most readers in clinical practice already get plenty of exercise running around the wards and cycling to visits, but those who don't should try fidgeting. Sitting and fidgeting uses a third more energy than lying motionless, although the exact amount of the difference varies between individuals (American Journal of Clinical Nutrition 200;72:1451-4). To work off 200 kilocalories—the digestive biscuit you had with your coffee—you need to fidget for about 2.5 hours.

Using the stairs instead of the lift is another relatively painless way to burn off excess calories, and a few posters in the right place can motivate people to do it (Journal of Epidemiology and Community Health 2000;54:942-3). Shoppers in a Birmingham mall responded well to a poster between the lift and the stairs suggesting that they take the latter. Defaulters most often said that the lift was easier, or that they were too lazy to use the stairs.

British doctors may be miserable about the state of the NHS, but they are not as pessimistic as Canadian doctors, more than half of whom think that their ability to care for patients has been eroded and is likely to slide further (Canadian Medical Association Journal 2000;163:1496). US doctors were close behind in a survey covering five developed countries, followed by New Zealand, then …