At a time when NHS bodies are under more financial pressure than ever before there is one anomaly which is worth highlighting. Personal injury victims can be paid damages on the basis that they will claim the cost of private medical care, but then such a person is entitled to keep the damages and demand […]
Category: Columnists
William Cayley: It’s not just the patient’s story that matters
Each patient’s story matters. It tells us who the patient is, and how he or she came to the present point or predicament. The story gives nuance, meaning, perspective, and context to all the medical information and data points that each patient presents. The story introduces us to the patient as a person. Beyond our […]
Richard Smith: Medical research—still a scandal
Twenty years ago this week the statistician Doug Altman published an editorial in the BMJ arguing that much medical research was of poor quality and misleading. In his editorial entitled, “The Scandal of Poor Medical Research,” Altman wrote that much research was “seriously flawed through the use of inappropriate designs, unrepresentative samples, small samples, incorrect […]
William Cayley: Evidence based medicine and practice change—get out front and push!
We’d hoped evidence based medicine (EBM) would improve patient oriented outcomes and clinical processes, but some fear the “EBM” movement is broken. However, it may not be just “EBM” as a movement that is broken—I am starting to wonder more and more about clinicians’ willingness or ability to apply evidence in practice, when it runs […]
Jim Murray: Some MEPs work very hard
I sometimes feel sorry for MEPs, and not just at Christmas. I’m thinking of those who do a good job as rapporteur on important dossiers, such as the revision of the Clinical Trials Directive. They put this on their website and in their press releases, but in most cases their constituents have no idea what […]
Simon Chapman: When will the tobacco industry apologise for its galactic harms?
Last week, four US tobacco companies finally reached agreement with the US Department of Justice to fund large scale corrective advertising about five areas of tobacco control. Each advertisement will include the statement that the companies “deliberately deceived the American public.” The case against the companies commenced in 1999 and saw a 2006 judgment by […]
Richard Smith: Doctors and the Hollande affair
It’s hard not to be fascinated by Francois Hollande’s alleged (why do we keep bothering with this word?) affair with an actress with stories of two Parisian love nests, bags of croissants being delivered by security men for breakfast, and the president travelling by scooter for their assignations. But the bit of the story that […]
Richard Smith: Taboo over the private sector limits health development
In most low and middle income countries the private sector accounts for 60-80% of outpatient care and 40-60% of inpatient care. Yet aid agencies have largely ignored the private sector, severely limiting their impact. This week a small meeting organised by the Centre for Global Development in Europe discussed how attitudes might be changed. Some […]
Richard Smith: What is the future for hospices?
As I walked beside Clapham Common towards Trinity Hospice a famous BMJ phrase was ringing in my ears: “Hospice care is deluxe dying for the few looked after by dowager duchesses.” That may not be the actual quote, but the point was that hospices, funded mostly by charity, could provide an excellent death while most […]
Richard Smith: NCD among the bottom billion
My main job these days means thinking about non-communicable disease (NCD) in low and middle income countries (LMIC), but a paper in the Lancet suggests that I may be thinking in the wrong way. It’s always hard to shift your mental model dramatically, but perhaps I need to do so. I and the 11 centres […]