Cochrane systematic reviews provide perhaps the best evidence available on health, but do they improve the care of patients and shape health policy? This was the question addressed at one of the liveliest sessions at the Cochrane Colloquium in Auckland. Most people are cared for in primary care, but the full Cochrane reviews are useless […]
Let me tell you a story. I recently had the opportunity to listen to a woman whose mother developed vascular dementia. This is what I heard. A stroke caused expressive and receptive dysphasia along with a change in behaviour so, when stressed, her mother would become aggressive. Despite that, she lived in her own home […]
So David Cameron does not know the meaning of the phrase Magna Carta (The Great Charter) or who composed the music to Rule Britannia (Thomas Arne). The prime minister was appearing on the David Letterman show in the US following in the footsteps of his political adversary, Boris Johnson who also made a similar appearance […]
The idea of combining antihypertensive drugs, a statin, and sometimes aspirin into a polypill to prevent heart attacks and strokes is now a dozen years old, but still no drug is licensed in a high income country. This week researchers, funders, regulators, policymakers, and drug manufacturers gathered together in Hamilton, Canada, to review and perhaps […]
In the debate about the NHS reforms that occupied so much Twitter space before the Health and Social Care Bill was passed, Trish Greenhalgh quite properly challenged me to use the five whys approach that Taiichi Ohno used within Toyota and that I had been advocating be used for other issues, to drill down to […]
There is increasing acceptance that the current model of healthcare is wrong. Rather than episodic care triggered by acute events and delivered in hospitals, there needs to be continuous care that includes the patient as a key asset able to self or co-manage his or her condition(s). So much of the discourse on the future […]
“Even in comparatively poor countries we find scientific knowledge and trained intellects regarded as sound public investments, and the popular voice applauding a liberal application of public money to secure them.” Isambard Owen, 1904 […]
The large gilded hall of the Musikverein in Vienna is instantly recognisable to most people from the annual New Year’s concert dedicated to the Strauss family and their contemporaries. In real life it is no less magnificent, although it feels smaller than the images projected by the televised event. Endowed with a crystal clear acoustic […]
I must begin by making clear that I think the BMJ magnificent, much improved from when I was the editor. I particularly applaud the introduction of indepth investigative journalism. I’m also extremely grateful to the journal for publishing my blogs, some of which seem to push close to the edge of sanity. But I want […]
It is a bold and foolish person who advises others how to live, but I can’t resist a little advice. I’m not going to tell you how to be smarter, sexier, stronger, or richer (as I have no idea) but rather how to start the day. My advice is simple: 90 minutes reading good books. […]