Intended for healthcare professionals

Letters Health care and markets

We need to be more pragmatic

BMJ 2008; 336 doi: (Published 03 January 2008) Cite this as: BMJ 2008;336:8
  1. Adam Paul Fitzpatrick, consultant cardiologist
  1. 1Manchester Royal Infirmary, Manchester M13 9WL
  1. adam1{at}

    I worked for two years as an attending physician at the University of California, San Francisco, and the past 12 years as a consultant in the NHS. Rampant commercialism in health care doesn’t work well,1 2 but nor does health care by slavish social dogma, as in the United Kingdom.

    In my experience in the United States, university medicine was of a high calibre; knowledge and procedural skill levels were the best I have encountered, and patients were treated …

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