Ask somebody “What is the NHS?” and they are likely to answer to “The people who work in it, the buildings they work in, and the tools they use to do their work.” But it clearly isn’t that. The people who work in the NHS come and go, and none were working in the NHS […]
So, the junior hospital doctors’ “contract” has been published, and the secretary of state for health, described in BMA documents as “SoSH”, which is also an obsolete word meaning a dull, heavy sound or a thud, has called it a “draft final version”—a contradiction in terms. The word “draft” comes from an Indo-European root meaning […]
Last week I gave a talk to the International Society of Medical Publication Professionals entitled “Medical journals: time for something different.” My core argument was that “Medical journals have played an important role in spreading medical knowledge, but they are now beset with problems. Some will transform, most will disappear. New forms of disseminating medical […]
To recap: my definition of a pharmacological mechanism, slightly expanded from before, is “one or more entities and activities organised spatially and temporally to interact in such a way as to be associated, depending on the milieu, with a phenomenon or phenomena”. In what ways can pharmacological mechanisms, so defined, be used as evidence? The […]
In the last month I have had two wonderful musical experiences in Dublin, each causing me to reflect on one of the key challenges of medicine, that of getting to the core of what is troubling people who seek medical attention. Each of the performances was from music ensembles who seek to perform music in […]
Invited last week to the MuST9 philosophy conference—Evidence, Inference, and Risk, in the Center for Mathematical Philosophy in Munich’s Ludwig Maximilians Universität, the ninth in a series held in turn in Munich, Sydney, and Tilburg (hence the name)—I mused on the definition of mechanism, particularly in relation to physiology and pharmacology. In my general approach […]
The commonest undergraduate degree of students entering the medical school at University of California Irvine is philosophy. The medical school, traditionally the richest and most arrogant of university departments, has at UC Irvine reached out to the philosophy department for help. At a conference there last month I met a student who is simultaneously studying […]
I’ve been thinking a lot recently about MPs doubling as ministers of state politically responsible for key public services. What are the characteristics of a good or bad one? I’ll start by saying upfront that while I understand the need for democratic accountability and oversight for large amounts of public money, even the system we […]
I recently asked whether, in light of the relative drop in the number of trainees entering family medicine in the US compared to other specialties, we can continue to find ways to bolster the strengths of primary care, both in medical education and practice—since we know that primary care “helps prevent illness and death.” Some […]
If you have meningitis how well you do depends on the medical team, whereas if you have diabetes it depends mainly on you, the patient. These days most of healthcare is about patients with long term conditions, usually multiple conditions. So the old style of healthcare when sick patients could be rapidly cured, which many […]