I had spent five years as a senior house officer in the late 1980s and early 1990s trying to decide on a specialty, sitting exams, and changing my mind several times. Eventually, having taken an accident and emergency post—largely to pay the mortgage—I finally found a subject that was sufficiently broad to gain my interest. […]
Pietro Dionisio: The shortage of medicines in Venezuela is a humanitarian crisis
Venezuela is a powder keg. A major objective of the Chávez government after the Bolivarian revolution was to improve healthcare for the Venezuelan people, and they built thousands of new clinics, hospitals, and diagnostic centres across the country. But now there is a grave risk that all this progress will vanish and those living in poverty […]
John Davies: Getting ready for Rio
As the Olympic Games approach, I’m beginning to make preparations. I’m going there! I got the bug at London 2012. They asked the public to volunteer because no games can happen unless thousands of people give their time and expertise. Staff are appointed in all trades and professions that are needed for such a mega event […]
Sarah Mitchell: It’s time to change end of life conversations for better care
What can we do to improve care for people who are dying? Someone dies every minute in the UK. In healthcare we know we need to improve what we are doing, but the messages in guidelines and strategies have changed little over recent years. Public health agendas in palliative and end of life care are […]
Collette Isabel Stadler: How poor provision of mental health services adds to the risk burden for children in care
If you are a 65 year old male smoker with hypertension, hyperlipidaemia, and a family history of cardiovascular disease, the QRISK calculator informs a physician that your chances of having a heart attack in the next 10 years are 47%. Health professionals leap into risk modification and disease prevention mode; you are referred to smoking […]
Kate Adlington: Is there such a thing as the “right diagnosis”? Review from the Diagnostic Error in Medicine conference 2016
As doctors, we probably already consider ourselves honorary members of the Society to Improve Diagnosis in Medicine (SIDM). It’s essentially part of our job description. But there is an option to become a fully paid up member. Founded in 2011 by US doctor Mark Graber, the SIDM is an international organisation that is dedicated to honouring […]
Samir Dawlatly: Who are the casualties of the battle against cancer?
The NHS is expected to find efficiency savings of £22 billion over the next four years or so. As well as implementing new structures and coping with the potential financial fallout from Britain’s exit from the EU, it is also expected to perform better in many sectors in terms of health outcomes. One such area […]
Richard Smith: Journals, fraud, science, and misaligned incentives
Journals, like the mass media, have a major part to play in exposing scientific fraud and other kinds of misconduct. In contrast, as I’ve argued many times, there are better ways now to disseminate science. Yet sadly and ironically, exposing fraud is risky and expensive, whereas publishing science is often highly profitable. The incentives are all wrong. […]
Richard Lehman’s journal review—25 July 2016
NEJM 21 July 2016 Vol 375 MenB vaccination for students 220 We’ve been waiting for decades to get a vaccine against Neisseria meningitidis serogroup B. But now that it’s arrived, it’s hardly the kind of thing that gets people looking for champagne bottles in the fridge. It’s an expensive way to prevent a rare disease, […]
Jeffrey Aronson: When I use a word . . . A ban to abandon
Recently, Trish Groves reported in The BMJ that some conference organisers would like to ban the use of Twitter and other social media at conferences. The main concern seems to be the transmission of pictures of speakers’ slides, which may contain otherwise unpublished data. I say “otherwise” because many do not seem to realise that […]