From April 2004, patients in the United Kingdom will have access to all letters written about them by health professionals. Researchers recorded a range of responses when patients received a copy of the assessment letter that an adult psychiatry clinic sent to their general practitioners. Only two out of 76 patients found the letters unhelpful, and 83% said they wanted to continue receiving them. But in 17 cases psychiatrists said that, knowing a copy would be sent to the patient, they had omitted some of the information they would usually have included (Psychiatric Bulletin 2004;28: 40-2).

Patients admitted to Johns Hopkins Hospital, Baltimore, had their lung function assessed by an independent investigator. A quarter (26%) of 153 general medical patients were found to have airway obstruction. At discharge only 40% of the patients who had been identified as having obstructive lung disease were receiving bronchodilator medication. The report in Chest (2004;125: 106-11) concludes that obstructive lung disease is common and is usually unrecognised and untreated.

Surgeons and gastroenterologists have for many years disputed which branch of the specialty can claim the best treatment for gastro-oesophageal reflux (known as GERD in North America). The …