Several months ago, I and 17 999 other general practitioners received, with the morning mail, a package marked “URGENT.” Naturally my eye was drawn to this word, 5 cm long and 1.5 cm high, in red upper case letters. As a GP I receive numerous letters, messages, faxes, and emails every day. A few of them are trivial, most purely informative, and some crucially important. Without the luxury of a personal assistant, I have to determine the priority and importance of these messages myself. I took the apparent importance of this piece of correspondence at its word and opened the package, only to discover it was an unsolicited pharmaceutical advertisement for an expensive bisphosphonate. I was being urged to prescribe this new medicine for post-menopausal women to prevent bone loss and fractures. (By no means do I wish to undermine this particular patient group, and their need for bone protection, but I do not believe prescribing for them in this context is an “urgent” matter at 8 30 on …