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The article by Professor Salmon and Professor Hall (February 2004, JRSM1) was refreshing. Patients' choice and empowerment, it seems to me, are issues which far too often degenerate into a politically correct smoke-screen. Behind it we hide the fact that, in the current NHS, patients have precious few choices. Many cannot even receive timely treatment for their most urgent complaints. Similarly, the talk about patient empowerment and coping skills distracts from the unfortunate fact that we live in a time when more and more of us can cope with less and less.