As the year draws to a close, scrutiny of A&E performance will once again become a regular topic of media interest. This attention is as dichotomous as the four hour standard that arbitrates good and poor performance, yet overall both are welcome. A downgrading of the standard would lead to a rapid decline in patient […]
Will Stahl-Timmins: Almost impossible cancer spaghetti
NICE guidelines, produced by the National Institute for Health and Care Excellence, are detailed, and sometimes lengthy documents. They are an attempt to summarise all available evidence on a health topic, supplemented by expert opinion where evidence is not available. The BMJ has recently been publishing quite a few summaries of these NICE guidelines, aiming […]
William Cayley: Is the Good Samaritan the wrong metaphor to use for doctors?
A story from the Christian New Testament has provided the literary namesake for countless medical facilities, as well as legal and ethical principles guiding care for those in need, but it may be the wrong illustration—or at least, not an adequate one. The “Good Samaritan” story is told in the book of Luke to answer […]
Vithika Pande: Lessons from dais—can we learn from traditional systems?
Many attempts have been made recently to better understand the social determinants of health (World Health Organization report “Commission on Social Determinants of Health). However, understanding health from a cultural lens is equally important and it is essential to consider this while designing health policies and programs. In India there has been a rich and diverse set […]
Jane Feinmann: Joshua’s story and its impact on patient safety
Like most people who complain about unsafe healthcare, James Titcombe’s six year battle to hold Morecambe Bay Trust to account for the death of his nine day old son in 2008 was motivated “by the desire to prevent similar tragedies happening to others.” And like many, as he explains in his new book, Joshua’s Story, […]
Will Marsh: Compassion and contracts—a leadership critique
At this year’s London Psychiatric Trainee conference, I listened to Penelope Campling speak eloquently about the importance of compassion in the delivery of healthcare. In her book Intelligent Kindness, she argues that when we fail to promote connectedness between staff, and kinship with patients, we fail to address the “key dimension of what makes people […]
Richard Lehman’s journal review—7 December
NEJM 3 Dec 2015 Vol 373 CPR with or without breaks 2203 Cardiopulmonary resuscitation for cardiac arrest outside hospital carries a mortality risk of more than 90%. It is usually assumed that the death rate would otherwise be 100%, but trials of CPR don’t ever include a non-intervention arm, so we don’t really know. In […]
Suzanne Gordon: Medicine’s F Word—Fail
“The patient failed” this or that therapy. I first heard medicine’s F word almost 30 years ago when I was having a casual conversation with an oncologist in a break room on the hematology/oncology unit. The oncologist—an earnest man devoted to his patients—was talking about a man who was dying of cancer. “Well,” he said […]
Ted Willis: Seven days to save the NHS?
For several months now we have been hearing the government argue that the NHS should provide a “seven day service.” Initially, it was maintained that this provision was required so that working people could see doctors without taking time off work. To many people it seems a no brainer. If Tesco can be open on […]
Jeffrey Aronson: When I use a word . . . Keep on twisting
I don’t know why I let Jeremy Hunt, the BMA, and Acas get in the way last week, when I was progressing with my exploration of different types of twisting. As I was saying, several Indo-European roots connoted twisting and turning. I began with UER and then made a start on PLEK, but there’s more […]