• The junior doctors’ contract: how did we get into this mess? With junior doctors about to vote on whether to strike over government plans to impose a new contract on them, Tom Moberly’s feature explains how and why the negotiations collapsed. […]
Tracey Koehlmoos on working as a policy adviser in the US Marines
And so…after two years and seven months at the Pentagon as the Special Assistant to the Assistant Commandant and Senior Program Liaison for Community Health Integration in the United States Marine Corps, I moved on without fanfare to a new position with an equally long title within the Department of Defense. It was a tremendous […]
The BMJ Today: Practising what you preach, corporal punishment, and scientific misconduct
• Walking the walk? Drug and device manufacturers have been keen to publicise their rhetoric to share clinical trial data, but is it happening in practice? Mayo-Wilson and colleagues found out by asking Astra Zeneca for data from trials about quetiapine. After 9 months of correspondence their request was declined. Is this a typical scenario? We […]
Richard Smith: If Volkswagen staff can be criminally charged so should fraudulent scientists
A man who steals a milk bottle may face a criminal charge. In contrast, a scientist who invents data, defrauds funders, and publishes fabricated data that may lead to patient harm is highly unlikely to face criminal charges. The news that Volkswagen staff may be criminally prosecuted for manipulating emission tests raises again the question […]
The BMJ Today: Diagnosing miscarriage and IBS
• When is it safe to diagnose a miscarriage? There has been some debate about miscarriage diagnostic criteria over past years, with evidence emerging in 2011 that criteria at the time might be too liberal. Newer 2013 criteria were more conservative, but are they conservative enough? This week The BMJ published a large multicentre prospective […]
Richard Lehman’s journal review—28 September 2015
NEJM 24 Sep 2015 Vol 373 1220 I suspect that good randomized trials of common procedures are difficult to do. Each French doctor probably has a favourite way of gaining central venous access, probably dependent on how they were first taught. But in this trial they were commanded to use the femoral, jugular, or subclavian […]
What can we learn from the success of the polio eradication initiative in India?
Popular opinion from many failed previous health programme implementations is that vertical programmes are resource consuming and might not be very helpful to strengthen health systems. [1] The same was said for polio eradication programmes a few years ago. But I tend to disagree due to my experience of working on this programme for many […]
Jeffrey Aronson: When I use a word . . . Adam’s apple
The Hebrew name of the first man, Adam (אדם), was also used to mean “man” itself, although the more usual word is “ish” (איש). The origin of the name is unknown, but the punning author of Genesis juxtaposes the name Adam with the word for the dust of the earth, in Hebrew adamah (אדםה), from which […]
David Zigmond: Competence or compliance? The corrosive cost of professional practitioner appraisals
Current appraisal systems sacrifice more of value than they can assure. Clarifying why and how this happens gives us wider insights into our ill faring welfare systems. “The more laws, the less justice” German Proverb Some healthcare management axioms seem incontestable: all our healthcarers should have a good standard of human and technical competence; these […]
Neville Goodman’s metaphor watch: Blind alleys and wrong trees
Research is difficult. Long hours in the laboratory, or tedious hours in the clinic, guarantee nothing. There are lots of blind alleys, dead ends, cul-de-sacs, false trails, wild goose chases, and red herrings; lots of barking up the wrong tree and flogging dead horses. Like single words with similar meanings, these synonymous metaphors are subtly […]