Epidemic of cardiovascular disease in South Asians

can be difficult to achieve as medicine becomes more complex, fragmented, episodic, and impersonal.Understanding medical altruism is also likely to be important in workforce planning particularly if, as in the UK National Health Service, recruitment and retention of medical and nursing staff are problematic.It may well be that the conditions that encourage clinicians to join and stay in their posts are not dissimilar to those that are needed for the development of altruistic behaviours.If it is also true that the maintenance of these behaviours depends on the recognition of individuals with similar characteristics-clinical and professional values-and on the expectation of reciprocity, then there is a strong message here for managers and policy makers.Disenfranchisement and disengagement are dimensions of demoralisation and burnout, a constant threat to physicians' health. 9Workforce planning needs to be more than a numbers game and must pay explicit attention to the working conditions, incentives, and rewards provided for all healthcare workers.