It's been good to exercise a different bit of my brain and think about the philosophy behind why we do what we do in medicine. He looks at the various ways we try to explain what is important and organise how we work - managerialism, consumerism and the market, legalism, duty etc. - and suggests a more fruitful way might be to look at the virtues required to be a doctor, the " internal goods " to be gained and the need to emphasise human flourishing in both staff and patients. What he doesn't do is tell us how to do it!