Richard Smith was the editor of The BMJ until 2004.
Bain, the global consultancy, produces what it calls “a pyramid of employee needs,” and on the day when junior doctors are striking it’s instructive to see how well the NHS is doing in meeting their needs. The bottom of the pyramid is “satisfied employees,” and the very fact that junior doctors are striking suggests that […]
Whenever I wander through ruins I imagine people centuries hence picking through the ruins of my world and wondering about the people who lived there. We can learn from ruins, and as I walked through those of the Mayan city of Chichen Itza last week I learnt not only about the Mayan world but also […]
Forty years ago at medical school I learnt the “rule of halves” that states that among those with a chronic disease, like hypertension, half are diagnosed, half of those diagnosed are treated, and half of those treated are treated adequately. Last week I learnt at a meeting organised by Public Health England that England has […]
Several times when I was the editor of The BMJ the journal was declared the worst medical journal in the world by an ME association. Sometimes we shared the award with The Lancet. At another time my wife was telephoned and told that if I didn’t take a different line on ME (which is better known […]
Trying to define a good doctor is as elusive a task as trying to define a good life or a good death. Like good lives and deaths, good doctors will come in many forms, and I search for them constantly as I read. Most doctors in novels are “bad”—fools, crooks, sadists, and cold fish. But […]
Caryl Churchill’s 45 minute play on death at the National Theatre begins with people at a drinks party after a funeral. Nobody is much upset. “The waters close over very quickly after a death,” my friend Vitek said to me last week. People talk across each other. There is no real communication. We learn little […]
Should we be responding to hypertension in low and middle income countries? Of course we should. Hypertension kills 10 million people a year prematurely, and 80% of those deaths occur in low and middle income countries. Less than 5% of people with hypertension in those countries have their blood pressure well controlled, and yet we […]
Big data, as we all know, is going to save us. Used well it will make health systems solvent, introduce immortality, cool the planet, bring peace in the Middle East, and create a global pandemic of love, health, and happiness. But not yet—as we are still at the beginning. For now its achievements are more […]
There is great reluctance in Britain to consider any other kind of funding for the NHS apart from taxation, but we are surely close to a time when we will have to consider it. This morning I awoke with the thought, which felt terrible, that funding through taxation is a straitjacket that is causing increasing […]
Yesterday I was in The Cholera Hospital in Dhaka, Bangladesh; today I’m reading about a highly emotional debate about the causes and treatment of cholera that took place in India in the 1857, during the Indian Mutiny. Both experiences have taught me something, and you might learn something as well. Cholera today Cholera is endemic […]