Clin Med
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Having children will inevitably, to a greater or lesser degree, have a negative impact on a woman doctor's career progression. It is a major challenge to create a working environment which optimises her career progression, and at the same time enables optimal parental care for her children. ⋯ The woman doctor's perspective as a mother is also put to one side. The major burden of childcare for the foreseeable future will fall on the mother, but the key issue (for parents and administrators) is that the period of intensive childcare is limited and, once complete, both careers can proceed at full pace.
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The drive to address social determinants of health is gaining momentum. Appreciating that health outcomes are only partly affected by healthcare, clinicians and clinical communities can play a significant role in this crusade by action at local, regional, national and global levels. A concerted and systematic focus on integrating and industrialising upstream interventions at every healthcare encounter is essential to prevent future illness, thus enabling a paradigm shift in the healthcare service from being one of illness management to health preservation. ⋯ Today, with a global economic crisis and challenged public sector funding, the need to address prevention has never been more pressing. Clinical engagement at all levels, from the front line to the boardroom is vital. Clinicians must address access, communication, strategy and commissioning to fulfil a professional responsibility to become and remain the corporate memory of a health service focused on preventing illness while simultaneously delivering cost-effective healthcare.