Two London-based organisations, the Royal College of Physicians and the King’s Fund, have combined to produce a document with the above title.1 Even if you are not a Member or Fellow of the College, the 56-page document—which derives from a 2005 publication from the same College2—is well worth perusing; in fact, it demands careful study by influential medical leaders and decision makers.

It starts off well by boldly and unambiguously stating that “there is a tendency in our over-centralised and largely state-controlled health system to blame government and politicians for all the ills facing our profession. Yet it is clear that many of the pressures and challenges on the medical profession are not confined to the UK or to this profession and instead reflect wider …