It is not often that I find myself quoting Moshe Dyan, but his aperçu that you don’t make peace with your friends has gained wide currency. In medical terms this might best be translated that our debates and advocacy are best shaped in dialogue where there is true opposition and dissent. I was reminded of […]
Category: Columnists
Kieran Walsh: Am I getting value for money out of my medical school tuition fees?
In the nineteenth century there were few standards in medical education. Students would often do an apprenticeship with a general practitioner and gradually gain experience in the trade. They had to pay for their education—which barred all but those from the privileged classes from becoming a doctor. For those who did persevere with their education […]
Richard Smith: At last, a consumer led NHS?
The two driving principles of the new NHS Commissioning Board are transparency and participation. If they are applied radically then they can transform the NHS, said Tim Kelsey, National Director of Patients and Information for the board, at Monday night’s meeting of the relaunched Cambridge Health Network. He envisions an NHS where patients are empowered […]
Muir Gray: Defining the population for systems of care
Read the rest of this series of blogs about designing and planning population based systems of care here. Step 2: Defining the Population Having defined the scope of the system, what is to be included and what is to be left out, the second step is to define the population to be covered and served […]
Richard Smith: Reporting guidelines for case reports
The Equator network of guidelines on reporting health research, a hugely valuable resource, has 200 guidelines, but none of them are for case reports. So as case reports seem to be returning to respectability a group of us gathered last week at the University of Michigan to start the process of producing guidelines for publishing […]
Desmond O’Neill: 50 shades of stroke
Language in Ireland can be tricky and subtle, with many shades of meaning possible for even simple words such as “stroke,” as our minister for health discovered to his chagrin in the last few weeks. A coalition government of moderately right wing and moderately left wing parties assumed office in 2011 in financially difficult circumstances, […]
Julian Sheather: Safeguarding adults—respecting freedom, maximising welfare
I was in Bromley recently at an adult safeguarding conference. It was in some respects a melancholy day. We heard about Brent Martin, a 23 year-old with learning disabilities and a mental disorder beaten to death by members of a gang who temporarily befriended him, though largely for access to his benefits. He had been […]
Richard Smith: Stratified medicine vs the polypill
In the past month I’ve attended contrasting meetings on the polypill and stratified medicine that leave me wondering about the future of medicine. The problem that the polypill tries to solve is that only about 10% of people in the world get the simple drugs that could dramatically reduce their chances of having a heart […]
Muir Gray: Defining the scope of systems of care
Read the first in this series of blogs about designing and planning population based systems of care here. Step 1: Defining the scope The focus of a system may be: A symptom such as breathlessness. A condition such as inflammatory arthritis or multiple sclerosis. A sub group of the population such as frail elderly people, […]
Richard Smith: Stratified, personalised, or precision medicine
Doctors know that many of the patients they treat with drugs will not benefit. Many patients know that too, which may be why some don’t take their drugs. The simple concept behind stratified medicine is that we become smarter at identifying the patients who will benefit. What has long been an aspiration is slowly becoming […]