Getting end of life care “right” makes a real difference to people with cancer. The lessons learnt from palliative care for cancer need to be applied to other fatal conditions, say Scott Murray and Aziz Sheikh. How can we ensure reliable services for everyone, asks Joanne Lynn.

Doctors should pay greater attention to managing the risk-benefit relationship to improve care of patients over 65, urge Jerry Avorn and William Shrank. The challenge of safer prescribing, says Anne Spinewine, lies in shared decision making. Audio coming soon.

Patients with chronic pain deserve better treatment, says Henry McQuay. while Dawn Stacey and colleagues describe how the care of people with osteoarthritis is improving. Shared decision making between patients and clinicians is making a difference.

The growing problem of binge drinking among young women is one that must be dealt with at a societal level, says Ian Gilmore. Nevertheless, doctors can make a difference at an individual level, and Brenda Reiss-Brennan and colleagues describe one US quality improvement intervention in primary care.

With ever increasing pressure on doctors’ time, Iona Heath wonders whether primary care can really meet the needs of elderly people at all, while John Wasson suggests ways for doctors to make a difference to the care of older patients that don’t require extra resources or staffing.

Resistance to drugs in many common childhood infections is a growing problem in poorer countries, says Zulfiqar Bhutta. Effective programmes to combat resistance are within reach, argue Ralph Gonzales and colleagues, but we must move swiftly to make a difference.