In England alone there are about two thousand surgeons in management and leadership positions in addition many young surgeons see the need to develop understanding of management and leadership to prepare them for the health service or academic jobs.
One source of evidence is that the people who walk say that walking makes them feel, and look, good. But this does not prove that walking is beneficial or, as is said when new medical treatments are evaluated, that it does more good than harm. It might be that people who feel good about themselves and who are healthy, walk more than people who are depressed or unwell, and there is probably some truth in that
A system is a set of activities with a common set of objectives and an annual report. For each objective one or more criteria are identified to measure progress or the lack of it and for each objective standards have been agreed and there are three standards:
Erewhon has a population of 5 million people. It is a population with an age distribution typical of most developed countries with about 15% of the population over the age of 65, and the population is ageing. Most live in cities, with two big cities each with a medical school, and city living is increasing and there are some thriving towns and some depressed industrial areas and large sparsely populated rural areas.
For decades to come need and demand will increase faster than the resources available. Society will need to maximise value from the resources it allocates for public services including healthcare and to do this ten questions need to be addressed
There is a negative, over pessimistic view of old age and older people. This derives partly from a failure to understand how many of the problems of old age are preventable and are not due to the ageing process. Poverty, for example, leads many people to withdraw from society but it is not a consequence of ageing. It is a consequence of social inequality and injustice. Some individuals can retain a positive attitude in the face of the these negative pressures but this requires resilience and a definitely decision to think positively about one’s position, capabilities and potential.
For most people, old age is feared because it is associated with disability and disease, and it is true that the prevalence of disease increases decade by decade. However, the ageing process is not the principal cause of disabling disease, and many of the disabling diseases of old age are preventable.
The Actual Rate of Decline is faster than the Best Possible Rate of Decline, that is the rate of decline due solely to the ageing process and the difference between the two is the Fitness Gap. Both the point at which physical decline starts, and the rate at which it proceeds is for the first few decades determined by loss of fitness, and loss of fitness is determined by social factors, namely by the decisions people make about their life and the pressures which influence them decreases
There are only two phases of life, the phase of growth and development and the phase of ageing and functional decline which is at present untreatable but there is great interest, and considerable investment, in the search for what would have been called an Elixir of Life but is now called Regenerative Medicine
The Ageing Process is normal, biological and not pathological, and nothing can be done about it, for the present at least. But this does not mean that you should despair. On the contrary, you need to understand what is happening to you and how the three processes that cause much more trouble than ageing, at least before the age of ninety can be countered, how their impact can be reduced and how many of their effects can be reversed