Here is my third and final blog on the USA trip: After Seattle’s integrated care organisations, we visited CalPERS. They fund $6.7bn worth of healthcare for 1.3 million people (roughly twice what we have per person in Lincolnshire). They see themselves as “active” purchasers: managing the market to reduce costs. About two thirds of their members […]
Category: Columnists
Desmond O’Neill: One hundred years of flautitude
No geriatrician could pass up on the opportunity: a performance of a flute concerto written by a living composer in his 100th year by one of the greatest orchestras in the world, the Boston Symphony Orchestra. It took place without any formal linkage to the almost 4,000 delegates attending the Gerontological Society of America (GSA) […]
Martin McShane: Integrated reflections continued
Following our visit to Kaiser Permanente, we travelled north to Seattle and visited the Virginia Mason hospital and Group Health. Linked but distinct, the relationship between the two provided a contrast to Kaiser Permanente – though, as organisations seeking integrated care, there were common themes. We spent a day at Group Health and yet again […]
Richard Smith: Can information technology improve healthcare?
I doubt that anybody within airlines, financial services, or manufacturing goes to meetings to debate whether information technology can improve what they do. It already has. But in healthcare we’ve grown very sceptical about information technology. In fact information technology already has improved healthcare and much of what is done now could not be done […]
Martin McShane: Integrated reflections
Sir William Osler advocated the concept of a “quinquennial brain dusting“: which was my justification for taking a week out to visit some integrated care organisations on the West Coast of the USA, with a group from the NHS. I know we feel challenged in the UK, but the scale and nature of the challenge […]
Richard Smith: More on the uselessness of peer review
I know I’m becoming a bore with all this raving against prepublication peer review, but like all true bores I’m charging on regardless. And I’m fired up by the experience I’ve had in the past few minutes. Unsurprisingly, I’m a hypocrite as well as a bore, and despite my protestations I do a fair bit […]
Desmond O’Neill: Donizetti and the GP
It is almost certainly the most unique operatic experience in Europe. As you walk up a narrow street of terraced houses in a small coastal town in south-eastern Ireland, you enter a modest entrance and are suddenly in the middle of a sophisticated walnut-clad atrium. This in turn leads into a striking marriage of smart […]
Tracey Koehlmoos: Climate change, health, and security
On 17 October, I was fortunate to attend a daylong seminar at BMA House on “the health and security perspectives of climate change.” Uniquely, this programme pulled together medical and military professionals along with climatologists, zoologists, and politicians. The morning focused on threats to global climate, health, and security whereas the afternoon sessions focused on […]
Richard Smith: Battling over safe alcohol limits
Advice on smoking is simple: don’t smoke. But what should be the advice on alcohol? It can’t be “don’t drink,” nor can it be “drink less.” Doctors and governments think that they need to give guidance to people on alcohol—and mostly they do that by suggesting “safe limits” based on units of alcohol. But is […]
Richard Smith: A woeful tale of the uselessness of peer review
Let me tell you a sad tale of wasted time and effort that illustrates clearly for me why it’s time to abandon prepublication peer review. It’s the tale of an important paper that argues that we can screen for risk of cardiovascular disease using simply age. (1) I’ve already posted a blog on the implications […]