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  1. B Bhargava
  1. Correspondence to Professor Balram Bhargava, Executive Director, Stanford Biodesign India and Department of Cardiology, AIIMS Delhi, India; editor.innovations{at}bmj.com

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Dear colleagues, These are wonderful times of change for healthcare and how it is practiced. From the traditional ‘automobile’ hospital service model of ‘wheel-in-get-fixed-walk-out’, which works well for the healthcare problems of the last century—infectious diseases and trauma—the healthcare system has been grappling with the management of lifestyle and chronic diseases. The world has been unable to tackle the infectious diseases and lifestyle diseases have emerged as the major scourge of this century. Needless to say, the cost of healthcare has spiralled out of control and it threatens to destabilise the economies of the developed world and wreak havoc for developing economies; meanwhile underdeveloped economies still struggle.

While all of us are trying to tackle this problem, healthcare continues to move into homes for the elderly, day-care centers and people's homes. We are moving from a system of patriarchal physicians towards one of participative physicians who …

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