I used to be part of running a course for editors of medical journals, and on each course we’d encounter editors, usually distinguished professors, who worked evenings and weekends on journals for free. They did so as a contribution to their specialty and for a dollop of honour. In their naivety they imagined that the […]
In law, the capacity to make a specific decision has a binary quality. Somewhat like a light it is either on or off, you either have it or you don’t and there are no intermediate states. Yes capacity can fluctuate, the bulb can wink on and off, but at any one time we either have […]
Hospitals can be dangerous places. Two things happen to everyone admitted to hospital for more than a few hours—they are put to bed and are fed. Over half a century ago Richard Asher highlighted the obsession hospitals have with beds and the dangers of being confined to bed (BMJ 1947; doi: 10.1136/bmj.2.4536.967). Asher’s description of […]
Working as a doctor in Ireland has many positive aspects, particularly a warm human ambience and a remarkable love of the spoken word. On the debit side of the linguistic largesse is a leaning to the elliptical and the discursive, and a generalised tendency to soften the hard blows of life. A prime example of […]
I was once the editor of the BMJ and chief executive of the BMJ Publishing Group. I work for a $100 billion company. I’m an unpaid professor at both Warwick University and Imperial College London. But, mighty and pretentious as this sounds, I’m down there in the gutter when it comes to accessing scientific articles, […]
Proponents of integrated medicine want us to believe that they are offering “the best of both worlds” to their patients and claim that using a combination of alternative plus conventional medicine is preferable to conventional medicine alone. This approach allegedly extends our therapeutic options, respects patient choice, and provides compassion in healthcare. Alternative practitioners, they […]
Most of my work is concerned with non-communicable disease (NCD) in low and middle income countries, so I’ve got to know a fair bit about the subject. But yesterday I spent an afternoon at Imperial College listening to a series of short presentations on NCD in low middle income countries (LMIC), and I learnt a […]
There is a lot of angst around why research evidence takes so long to penetrate routine clinical practice. My view is that it’s a miracle that any of it makes it into practice at all because research derived information is very much the square peg to clinical practice’s round hole. The gold standard of experimental […]
Sometimes, it becomes apparent that what we have been talking about for so long is actually beginning to happen. Over the last few weeks we have been preparing for our Annual Accountability Review with the SHA. We have had our monthly cluster board meeting. We also had a meeting with the acute trust, looking at […]
For the last two years I have worked on a project about implementation research with more than 120 colleagues from across the globe: India, Chile, Mexico, Switzerland, Brazil, Canada, Uganda and more. The book, which was published by the World Health Organization (WHO) and the lesser known TDR is called Implementation research for the control […]