I’ve never been depressed. I’ve been down, sad, blue, but never depressed. But many family and friends, people I love, have been depressed. Some have tried to describe it to me. I learnt about depression as a medical student, but I’ve felt my understanding to be shallow. I wanted to know more about this pernicious […]
The European Medicines Agency’s definition of a medication error, published last year, is “an unintended failure in the treatment process that leads to, or has the potential to lead to, harm to the patient”. This, with the addition of a single word, “unintended”, is the definition that Robin Ferner and I suggested 16 years ago. […]
The village of Erice sits above the town of Trapani on top of a mountain about 750 metres above sea level in the north-west corner of Sicily (picture below). Its original name was Ἐρυξ, after the Sicilian king of that name, a son of Aphrodite and either Boutes, an Argonaut, or Poseidon, the god of […]
Having deconstructed part of the Conservative Party’s 2015 manifesto in last week’s blog, I thought that I ought to extend the favour this week to the Labour Party’s 2015 manifesto. Reading it, I was immediately struck by a phenomenon that I previously described when discussing weasel words—the flexible use of the words “we” and “our”, […]
For the first two million years of humans there were no doctors. People were born, flourished, became sick, suffered, and then died without doctors. Probably there were healers who danced, sang, rattled skulls, and used herbs but managed without microscopes and randomised trials. “Scientific doctors” appeared recently, and quickly—according to Ivan Illich, the critic of […]
In simple supply and demand terms, there are now more people living with chronic disease than there are doctors and other professionals around to help them. So how can the practice of medicine respond to this particular challenge? Here in the United States, there is growing interest in exploring the potential value of shared medical […]
“People almost invariably arrive at their beliefs not on the basis of proof, but on the basis of what they find attractive.” Blaise Pascal Can we make evidence based medicine work if we don’t understand the evidence? I appreciated this week’s BMJ analysis piece by Margaret McCartney et al, which gave recommendations for ways to make […]
I recently heard Jeremy Hunt, UK health secretary, on the Today programme claiming that the Government has a mandate for the controversial contract that it wants junior hospital doctors to sign. I can’t find that mentioned in the Conservative Party’s 2015 manifesto. The Indo-European root MAN meant a hand. The Latin word was manus, from which […]
It’s been really rewarding discussing quality improvement (QI) with colleagues at my trust. We’ve set up a few different resources for people to make use of. My favourite of these so far is something we’re calling a QI forum. Essentially it’s an unstructured meeting where we discuss QI in general with whoever turns up. We’re […]
When the NHS began in 1948 dental care was free at the point of delivery, but charges appeared as early as 1951. My current experience with dental services gives me a foretaste of how the whole NHS may begin to crumble. There is little left of one of my upper molars. My NHS dentist has […]