BMJ 2003; 327 doi: (Published 28 August 2003) Cite this as: BMJ 2003;327:509
  1. Linda Cardozo, professor of urogynaecology, London (

    Thursday morning starts, as any other, with an 8 am ward round of the postoperative patients. There are only three “survivors” to see, as the usual lack of beds meant the operating list had been severely cut. The ward sister warns that next week's operating list will also have to be reduced, because the department's “overspend” has resulted in eight beds closing. At 9 am the outpatients' clinic starts. Patients are waiting to be seen, and the medical students are eager, but many of the patients' medical records are unavailable and the electronic patients' records system is “down.” We have to decide whether to ask the patients to book another appointment or to try to sort out their problems without their investigation results. Some women have come a long distance and, naturally, are concerned or angry. “I am so sorry to keep you waiting” seems trite after its 10th repetition.

    The clinic finishes at 1 pm. Having dealt with the urgent queries and correspondence, and feeling thoroughly demoralised, I …

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