As a GP who didn’t train in the UK and who has never worked in the country as a GP, I follow the situation of general practice in the UK with great interest, but from a certain distance that characterises an outsider such as myself. I am well aware that general practice in the UK […]
Category: Columnists
William Cayley: Social history consultations and patient time vs patient time
Who are you, what do you need, and how do I figure out how to care for you? Fundamentally, those are the questions that drive every encounter between a doctor and a patient. A recent article in the New England Journal of Medicine calls for us to expand the “social history” facet of this to include […]
Neal Maskrey: How do we become an expert?
We humans often use analogies to help us solve problems. From our memory, we identify a problem similar to—but not exactly the same as—the one we are currently faced with, and apply the previous successful approach to the new problem. It’s called analogical reasoning. Sometimes we get great results, sometimes not so much. I recently […]
James Raftery: NICE and value based pricing—is this the end?
Since Andrew Lansley announced in 2010 that the NHS would in future use “value based pricing” in its purchases of pharmaceuticals, civil servants and (more recently) the National Institute for Health and Care Excellence (NICE) have been struggling to develop an approach for how this could be implemented. For the twists and turns, see previous blogs on the […]
Richard Smith: The joy of a hernia repair
I had a hernia repair recently, but the day turned out to be one of the pleasantest I’ve had in a long time. Can that really be true? Oddly, I looked forward to the day. It was partly the thought of being “made whole,” partly it being a different day from the normal, and partly […]
David Oliver: What would my mum think? The new CQC regime for care home inspection
On 9 October, the Care Quality Commission (CQC) announced the details of its new inspection regime for care homes, after a lengthy consultation and evidence gathering process. The proposals amount to a step change in the depth, breadth, and consistency of inspections. They attempt to move away from superficial visits, focussing on minimum compliance standards and […]
Richard Smith: A tobacco company CEO writes to his marketing department
Dear all, I see a great opportunity for us. You won’t believe this, but I’m at a public health conference in Sousse in Tunisia. I’ve come with my twin brother, a professor of public health. I am, of course, incognito. My brother asked me—yes, asked me—to come. Despite what you might think, we agree on […]
William Cayley: Thinking about Ebola from the sidelines
Recently I was staring at two dramatically different bits of “news” on my computer screen. Yet another story on the spreading Ebola outbreak was in one window, and the latest update on our practice’s clinical performance metrics was in the next window. News of an out of control plague, juxtaposed with little red and green numbers […]
Desmond O’Neill: Sky disc and the marvel of ageing
One of the great challenges of hospital medicine is retaining a sense of the marvel of ageing after a busy night on general take. The sheer complexity of the frail, multimorbid, and delirious nonagenarian can easily rattle junior trainees. Seeing beyond the losses to the accumulated richness of life experiences demands insight, but can be […]
Richard Smith: Improving health through the community in Tunisia
Tunisia, like all low and middle income countries, is having to respond to non-communicable disease after making good progress in reducing infectious disease and improving child and maternal health. Premature deaths from cardiovascular disease increased there by 35% between 1990 and 2010; they increased by 112% in Egypt and by 61% in Saudi Arabia—but fell by […]