I have read with interest the recent paper written by Macchi and Pavan1 concerning the problems about the quality of medical care at the time of economic crisis. I acknowledge that the efforts for “cruising between Scylla and Charybdis” have been huge, but the meaning of this old Greek myth is hopeless (“having to choose between two evils”). Besides the present economic situation and the present tendency to have an increasing number of old or very old patients in the western countries, some problems that can jeopardize the quality of care within a research and teaching hospital cannot be solved on a local basis, but in my opinion, they can be efficiently managed only under a general health plan.
