Deep brain stimulation for Parkinson’s disease is a remarkable therapy. Over lunch a colleague recently described how it transformed her life: from slow shaky dysfunctional movement to almost normal. It is one of those small cadres of treatments that does not need randomized trial evidence to know it works: turn off the stimulator and the […]
Category: Columnists
Richard Smith: “I’m the minister of health in a poor country”
I’m the minister of health in a poor country. Until last year I was a urologist. I was the president’s urologist and took out his prostate. To be honest, I don’t think it needed to come out, but he insisted. You don’t resist the president. He was delighted with the result and rewarded me by […]
Simon Chapman: Publishing horror stories: Time to euthanase paper based journals?
Every researcher has exasperating stories of the glacial pace of research publication. But as a former research journal editor of 17 years, I know that researchers’ ideas on what constitutes “glacial” varies enormously. I’ve received “hurry up” letters from authors a week or so after submission, and have often played a game with other editors […]
Desmond O’Neill: Striking doctors and a cruel cut
The strike was so much more straightforward in 1987. I was then a trainee member of the Council of the Irish Medical Organization and our task was to change an overtime rate of half of the hourly rate to one of at least time and a quarter, thereby removing the employer incentive for virtually limitless […]
Richard Smith: Medical journals: “a colossal problem of quality”
We knew that we had “a colossal problem of quality” when we began the peer review congresses in 1989, said Drummond Rennie, creator of the congresses, at the seventh congress in Chicago earlier this month. That problem is now better described and defined, in large part because of the congresses, but it’s even bigger than […]
Tiago Villanueva: How can doctors avoid becoming deskilled whilst working in non-clinical roles?
My main concern about working in a fulltime non-clinical position is becoming a less competent doctor by the time I start to see patients again (whenever and wherever that is). Doctors need to continually see patients and to regularly study and manage their own needs of Continuous Medical Education (CME) to avoid becoming deskilled, particularly […]
Tracey Koehlmoos: Life without health insurance in the US
If you are a UK citizen, you probably think we are barbarians. Go ahead and say it, “How can you be a wealthy nation spending so much on healthcare and everyone does not have the right to go to the doctor when they are sick?” I hear this all the time. However, the wheels of […]
Martin McKee: What on earth were the LibDems thinking? The tobacco industry and the party conference
Once, in a very different time long ago, no one would have seen anything wrong. An organisation purporting to represent Britain’s small shopkeepers set up stall at a party political conference, representing the views of its members to members of parliament, local councillors, and other party members. But this time, the decision by the United […]
Richard Smith: Learning at a meeting on global health
Earlier this week I attended a meeting at the Royal College of Physicians of Edinburgh on global health to beat my drum on the importance of non-communicable disease (NCD). Others were there to beat other global health drums, and I tried to learn all that I could from them. My main learning was that there […]
Mary E Black: Moving public health contracts out of the NHS and over to local authorities
The problem with us Brits is that when handed the impossible to deliver we actually go ahead and do it, methodically, honestly, and with many a sincere task and finish group. Which is probably why I am still staring at the list of my novated public health contracts, which came over just before 1 April […]