We are in the throes of debating the structure of the NHS for, I think, the 20th time in my professional life, but structure is, in my experience, of little importance compared with the two other components of an organisation – systems and culture, and what happens in the minds of individual clinicians and patients. […]
Category: Columnists
Tiago Villanueva: Quaternary prevention and disease mongering
One of the major advantages of being an active member of listservers, particularly international ones, is that I am in touch with leading colleagues around the world, and also I can learn about issues and think in ways that I would not otherwise have become aware of. I’ve had the chance to cross paths a few times with Dr […]
Richard Smith: Twenty tips for leaders
Some years a go a young friend who had worked with me became the head of a big organisation and asked for my tips on leadership. I’ve had some interest in leadership ever since I did a year at the Stanford Business School, and I enjoyed thinking of what to write to my friend. Perhaps […]
Martin McShane: Multilayered commissioning
I walked into a room recently which was jam packed with secondary care clinicians and managers. I was the lone commissioner. The meeting was a peer review visit to support the development and improvement of vascular services. I recognised the chair. We had both sat together in an ante room awaiting interviews for a senior […]
Liz Wager: Are journal editors like used car salesmen?
Yesterday, I gave evidence to a UK parliamentary inquiry into peer review (as did Fiona Godlee). (The session can be viewed here) Before the session I tried to think of an analogy for peer review that I could use to explain its usefulness, but also its variety and imperfections, to the MPs. Inspiration often comes […]
Martin McShane: Substantially amend
“If you feel confused you probably know what is going on.” Out in PCT land it is fascinating to watch and listen to all the noise and thunder in the stratosphere. The pause is in full momentum. The events of May 5th are having repercussions with posturing and postulations about substantial amendments to the health […]
David Kerr: T(w)eaching – using Twitter to teach patients
In the UK, we usually do it in groups – that is teaching patients with diabetes and other chronic disease how to self manage their condition. For example, a group approach is now used commonly for teaching patients with newly diagnosed type 2 diabetes, for those moving from oral hypoglycemic agents to insulin or when […]
Siddhartha Yadav: Diagnosing and treating the “Nepalese” microbes
A large portion of my work as a doctor in Nepal is to treat infections. Even in chronic conditions – COPD, diabetes, malignancy – I find that infectious micro-organisms take the toll more rapidly than the disease itself. It is fascinating how these minute beings have the power to bring human life to a standstill. Fever […]
Tiago Villanueva: Medical students should be guaranteed a job on leaving medical school
I’ve recently read with great interest the “for” and “against” debate in BMJ Careers on whether doctors should have a guaranteed job upon qualifying from medical school. It sounds reasonable that medical schools train the number of future doctors that is adequate to the needs of the population and that replaces the doctors that retire every […]
Richard Smith: Lunch with 90 health ministers in Moscow
Last week I enjoyed myself facilitating a lunchtime meeting of 90 health ministers at a meeting in Moscow on non-communicable disease. The meeting, like all global meetings, was something of a trial—see previous blog—but the lunch was fun. I wasn’t clear exactly who was there, but the meeting included ministers from China, India, Russia, US, […]