Andrew Herxheimer, an old friend and colleague, has died, aged 90 (picture). Andrew was primarily a clinical pharmacologist, but much more besides. His main interest was in improving patient care, particularly through better communication, and he took particular interest in adverse drug reactions and the activities of pharmaceutical companies. He founded the Drug and Therapeutics […]
Category: Columnists
Richard Smith: The death throes of national medical journals
Earlier this week the Canadian Medical Association fired the editor of the CMAJ and dissolved the journal’s oversight committee, which was supposed to protect editorial independence. While doing so, the board of the CMA—with impressive hypocrisy—reaffirmed its commitment to editorial independence. That’s two editors the CMA has fired and two it has “let go” in the past […]
Richard Smith: Is prison health better now it’s an NHS responsibility?
In the 1980s people in prison received a second class health service despite having a high prevalence of health problems. I visited many prisons at that time and wrote a series of articles for The BMJ. In those days the Prison Medical Service was part of the Home Office, and there was an argument that […]
Jeffrey Aronson: When I use a word . . . Imposition
As I foretold three weeks ago, the UK government’s health secretary Jeremy Hunt recently announced his intention to impose his contract on the junior hospital doctors. His cunctatorial Fabian tactics predicted it. Ramifications of the word “imposition” imply comment. Take the Indo-European root AP or APO, to reach, extend, or put. The derived Greek prefix […]
Richard Smith: Clinical leaders badly needed but not appreciated
All health systems need clinical leaders to flourish, but being a clinical leader is hard, particularly in the NHS. Those were the main messages from a recent meeting of the Cambridge Health Network. The reason we need clinical leaders, said Jonathan Fielden, currently medical director of University College London, but about to become director of specialist […]
David Oliver: If you want to explain what’s happening in the NHS, just look at schools and teachers
Imagine you are a teacher or headteacher in a good enough local authority school in an area with its fair share of deprivation and a shrinking funding envelope. The school increasingly struggles to balance its books, yet it’s told to make further savings. You are experienced and good at your job. You chose and trained […]
William Cayley: Single payer healthcare—is it here already?
Despite all the hand wringing and arguments over single payer healthcare in American social debates past and present, what most observers seem to miss (but patients and doctors know very well) is that we already have a long established single payer system of healthcare financing in the US—our healthcare is already paid for by the ubiquitous […]
Richard Smith: Qualitative research and The BMJ—hidden motives
I’m much amused by the pious positions taken by researchers and BMJ editors in the spirited dispute over qualitative research. The researchers are upset that The BMJ largely excludes qualitative research, and the editors insist that they do so to provide readers with research more likely to be useful to them. Both sides have hidden, […]
Jeffrey Aronson: When I use a word . . . Pro patria mori
Exactly a hundred years ago, on 19 February 1916, a British soldier, Captain Robert French, died in London after injuries sustained in battle. The following account is taken from his medical notes (picture). Captain French was wounded on 25 September 1915 while fighting with the 1st Battalion Royal Welch Fusiliers during the Battle of Loos. […]
Richard Smith: Systems thinking is essential for responding to obesity (and much else)
The recent discovery of gravitational waves allows a whole new way of seeing the Universe. With some similarities the recognition that the world is much more complicated and unpredictable than researchers thought opens up the possibility of an effective response to the global pandemic of obesity. That’s what Boyd Swinburn, professor of population nutrition and […]