Editor—As a citizen of one of the “developing countries” quoted by Wald and Law,1 I enjoy the free access to bmj.com, but I was amazed at the “collector's issue” of 28 June, published on my 55th birthday.2
I wonder whether the Editor's choice commentary is a product of astonished admiration, faithful friendship, or a critical view.2 This renewed tailored recipe, like that of the old eminent doctors, is now the new paradigm of epidemiological and trial based science: no more costly evaluations, risk stratifications, control visits. We don't even need doctors or to treat patients: we'll treat populations. Let's begin with developing countries, and after that treat them all. The next step will be delivering “Polypills” to babies in their bottles.
The basis of Wald and Law's outstanding paper is an incredible intellectual achievement because the authors quote themselves 14 times in the references, and no doubt remains that they are worthy of owning the patent for the Polypill.
Medicine is and should remain a patient based practice. Strategies that forget the essence of the doctor's job are forgettable, and good ideas such as combination treatments deserve encouragement and to be implemented in clinical practice; Wald and Law's proposal smells only to profitable business.
Anyway, I enjoyed reading the responses to this article instead of beginning my Polypill treatment on my birthday. I eagerly wait the next magic bullet of “007BMJ.” This might be—and why not?—the final solution to all human health problems.
Competing interests: None declared.
References
- 1.Wald NJ, Law MR. A strategy to reduce cardiovascular disease by more than 80%. BMJ 2003;326: 1419-24. (28 June.) [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Smith R. The most important BMJ for 50 years? BMJ 2003;326: 0. (Editor's choice.) (28 June.) [Google Scholar]