With the announcement of a National Dialysis Service, India is set to join the growing list of nations that provide free or highly subsidised treatment to patients with end-stage kidney failure. Dialysis is expensive—it consumes 2–6% of the healthcare expenditure [1], even though end stage kidney disease (ESKD) patients account for only 0.1–0.2% of the […]
Neville Goodman’s Metaphor Watch: Flashes, flies, and spanners
Knowing the vicissitudes of medical research, I expected a fair number of flashes in the pan and flies in the ointment, but neither is a common metaphor in PubMed. I had somehow thought that flash in the pan came from gold-mining: the miner, as he swilled water around his pan, being deceived by the flash […]
The 7th Global Patients Congress: Patient engagement in innovation for health
Sitting in the Edward Heath Room at the 7th Global Patients Congress at the Selsdon Park Hotel, Croydon, discussing universal health coverage (UHC) for all by 2030 (a target in the sustainable development goal for health), one is quickly reminded that if health is a political goal, then UHC is one of the ultimate political […]
Desmond O’Neill: HIP medicine
In the last month I have had two wonderful musical experiences in Dublin, each causing me to reflect on one of the key challenges of medicine, that of getting to the core of what is troubling people who seek medical attention. Each of the performances was from music ensembles who seek to perform music in […]
Tara Lamont: How was it for you? Reflections on patient experience research
“Expect to see blood in your semen.” This was the shouted afterthought from the clinician to a middle aged patient with prostate cancer across a crowded waiting room as he left the consultation. A room of strangers turned to look at him now thinking, as he pointed out wryly, about his sexual activity. Just a […]
Kamal R Mahtani: Evidence based mentoring for “aspiring academics”
There are times in our careers when we are not sure what to do next, whoever we are. We may lack experience or the confidence to decide what to do; or we may have made a decision and need a word of advice from someone more experienced, reassuring us that the idea was sensible. At […]
Jennifer Stein: To Rio or not to Rio—that is the question
Shakespeare’s question about being springs to mind when as doctors we are faced with change. Do we “take Arms against a Sea of troubles, And by opposing end them?” That is, of course, if we are able to do this. Rio is now a relatively common, though not ubiquitous, NHS IT replacement to medical notes, […]
Jeanne Lenzer: The Backstory—How I got the Cuba HIV story wrong
I recently reported on the World Health Organization’s announcement that Cuba was the first country in the world to halt mother-to-child transmission of HIV, an accomplishment praised by WHO’s director-general, Margaret Chan, as “one of the greatest public health achievements possible.” As I sat in the semi-circle of doctors who treat pregnant women in Matanzas, […]
Martin Roland: Who should have PSA testing for prostate cancer?
Doctors and patients are confused by PSA testing. In January 2016, the UK National Screening Committee recommendation concluded that “Evidence shows a benefit of prostate screening to reduce prostate cancer deaths by 21%. Despite this significant reduction, the major harms of treating men who incorrectly test positive still outweigh the benefits. A systematic population screening […]
Stuart Parris and Sonja Marjanovic: How to galvanise the NHS to adopt innovation
The NHS has a strong history of pioneering health innovations, but has traditionally been better at developing them than adopting them. To address these challenges, Sir Hugh Taylor, former permanent secretary at the UK Department of Health, is leading the “Accelerated Access Review.” The review team recently released its interim report. It puts forward five propositions for […]