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I too was saddened to read about the distress this family had obviously been caused . The distress is partially generated by the fact that it is possible for any doctor to be driven to the level of managing a patient as a workload problem rather than as has already been described " a human in distress " . Surely this is a burnout symptom and the practice has to address this as such . I feel that we have to be constantly aware of the maximum workload we can sustain and be brave enough to say enough is enough . We certainly come under pressure from all angles to take on more workload , whether it is from secondary care , unrealistic patient expectations or pressure groups . Perhaps the answer is to redistribute this workload further . To stop trying to keep one foot in the past and let some things go , so that we can take on these new responsibilities safely . By this I mean that we should be able to redistribute work throughout the primary health care team and not be afraid to let go . I for one still hope that the Primary Care led NHS will give us more room to define our own futures , but in order to do so we must respond to the challenge quickly before the powers that be act on our " behalf " once again . Roy Wallworth , Accrington Lancs . %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%