The rollercoaster ride of dispute talks between the British Medical Association representing “junior” doctors and the Secretary of State for Health points either to incompetent negotiations or to the political value of failure. Jeremy Hunt has claimed that 15 of 16 points were resolved, and that money was the only remaining issue. Junior doctors disagree. […]
Tracy Eastman on PACK—the Practical Approach to Care Kit
Bridging the evidence based medicine and local policy divide in primary care This blog is part of a series of blogs linked with BMJ Clinical Evidence, a database of systematic overviews of the best available evidence on the effectiveness of commonly used interventions. Primary healthcare is key to achieving the Millennium Development Goals and the broader […]
Paul Glasziou and Iain Chalmers: Is 85% of health research really “wasted”?
Our estimate that 85% of all health research is being avoidably “wasted” [Chalmers & Glasziou, 2009] commonly elicits disbelief. Our own first reaction was similar: “that can’t be right?” Not only did 85% sound too much, but given that $200 billion per year is spent globally on health and medical research, it implied an annual […]
Elizabeth Wortley: What the junior doctors’ strike taught me
Yesterday I came off the picket line having enjoyed some lively conversations with my colleagues. As passing drivers honked their horns in support, one of my colleagues observed that it’s a shame we don’t get together to provide more support for each other regularly. This started a discussion about our attitudes towards each other on a […]
Zhihua Zheng et al: Changing the perspective of off-label drug use in China
Until recently off-label drug use was controversial in China, as there is no legislation on it. Compared to on-label use, a lack of research for off-label use is deemed a risk to the patient. Nevertheless, some clinical practice cannot be done without off-label drug use. Sometimes off-label use of a drug is the only chance […]
Suzanne Gordon: Does the use of medical titles have an impact on patient safety?
A couple of months ago, I was invited to speak at an East Coast medical school and hospital. The group of physicians who extended the invitation—a female surgeon, and female and male internist—took me out to dinner the night before my talk. During the dinner conversation, we were all on a first name basis when […]
Richard Smith: Does the NHS meet the needs of junior doctors?
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 […]
Tiago Villanueva: Co-payments in general practice—the Portuguese experience
Since 2011, I’ve worked as a locum GP in Portugal’s national health service, where patients pay five euros for each appointment with a GP. Many people are exempt from paying, for exemple pregnant women, children up to 12 years of age, unemployed people receiving benefits, and patients who have had transplants. The co-payment to see […]
Merrilyn Walton: Sexism in medicine in Australia
Australian women, it seems, have had enough. Last week, politicians, a cricketer, and a specialist medical college apologized for sexist comments. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) recently got into trouble for planning a debate called Membership Before Maternity Leave: Should Every Registrar Have a Mirena to be discussed at […]
Richard Lehman’s journal review—11 January 2016
NEJM 7 Jan 2016 Vol 374 Predicting next week’s PET 13 This week begins with a toughie. Diagnostic test studies are always tricky to analyse. What matters to you as a clinician is the downstream value of the test—how it will help your management and improve the outcomes of patients. In the PROGNOSIS study a […]