“Stroke care was woeful,” said Dame Ruth Carnall, former chief executive of NHS London, in her sobering account of efforts to change the system. Less than 1% of patients had thrombolysis, less than 50% were treated in specialist stroke units, and standards were low across a whole range of indicators. Poor care, low standards, and […]
Category: Domhnall MacAuley
Domhnall MacAuley: International Quality Forum, day 1
On welcoming 3300 delegates from 80 countries to the International Quality Forum in London, home of the BMJ, Fiona Godlee (editor in chief, BMJ) asked us to remember the recent marathon trauma at the home of Institute of Healthcare Improvement (IHI) in Boston. All the more poignant as we congregated at Excel, the registration centre […]
Domhnall MacAuley: No easy prescription for physical activity
April 6th was World Physical Activity Day—did you miss it? Probably good news. Best to keep doctors out of it. Let me explain: I believe passionately in the benefits of physical activity, have researched it, published, editorialised, practised, and promoted it at every opportunity. The benefits of physical activity are undisputed and physical activity is […]
Domhnall MacAuley: Recognising good medical teachers
What is a good clinical teacher? Asked to host an awards ceremony, I have been thinking about it. At the BMJ we focus on “Helping doctors make better decisions” and in the education section we produce great content. That’s the easy part. Teaching is much more than reproducing this content. Its about passing on knowledge […]
Domhnall MacAuley: Evidence Live day two
Gathering evidence is clear straightforward science. Right? Not if you believe the speakers at “Evidence Live.” Today’s presentations were a challenge to believers. Fraud, misconduct, non disclosure of data, and conflict of interest were just part of the problem. Peter Wilmshurst (University Hospital of North Staffordshire) whose dedication to the truth in the face of […]
Domhnall MacAuley: Evidence Live
Essentialist or consequentialist? Patrick Bossuyt (University of Amsterdam) introduced this concept at the “Evidence Live” conference. Thinking about diagnostic testing he suggested that, rather than focus on the nuts and bolts of a diagnostic test (sensitivity, specificity etc), we might also consider the downstream effects. We know there are benefits to accurate diagnostic testing, but […]
Domhnall MacAuley: The future of general practice….is private
What will happen in general practice…now that we have so many part time portfolio doctors, practices where the focus is on performance related income, increasing delegation to practice nurses and nurse practitioners, and patients often seen by someone who has little knowledge of their past medical history? Out of hours care, for at least 8 […]
Domhnall MacAuley: Speaking of mid Staffs…..
Who should resign this week? The blame game continues with more Mid Staffs finger pointing. As newspapers identify further unpleasant aspects of the wider tragedy, there is a risk that we stop reading about it and just move on to the next news story. Sad, isn’t it, that the main messages from one of the […]
Domhnall MacAuley: A Harley Street at every crossroads
Harley Street. Even the name creates a picture. Executive medicine for the elite, cosmetic surgery for the glitterati, healthcare excellence and no expense spared. It’s more than just a street—it’s a brand with international recognition that would be the envy of any marketing campaign. A worldwide reputation that attracts patients from across the globe. As […]
Domhnall MacAuley: Politics, health checks, and well meant good intentions
When a politician speaks with passion and commitment about social inequality, I listen. When it is the chairperson of the Committee for Health, Social Services, and Public Safety, I listen carefully. Our practice is in an area internationally recognised as socially deprived, and, if politicians took a genuine interest and were prepared to invest resources, […]