It is easy to take universal health coverage for granted if you were born and raised in a European country, for example. But in low and middle income countries, people often have to somehow find the means to pay out of pocket for their healthcare, regardless of the availability of quality healthcare. Costs can quickly […]
Sarah Knowles et al: Hacking into health research
Patients get called a lot of things these days. Simon Stevens, for example, referred to them as the “renewable energy” of health services. The NHS White Paper called them “the heart” of the NHS. We at PRIMER (the Primary care Research in Manchester Engagement Resource), however, decided to call them hackers. More specifically, we invited […]
William Cayley: Overdiagnosis, uncertainty, and epistemology
Many thanks to Anita Jain for reporting on the “Overdiagnosis” session at the Cochrane Colloquium—I wish I could have been there. The suspicion that overdiagnosis (or at least over testing) is driven in part by the quest for certainty, is corroborated by an implementation study of the Vancouver chest pain rule. When the Vancouver chest […]
The BMJ Today: Is milk good for you?
America’s iconic “Got Milk?” campaign was pulled this year after a successful run of over 20 years. Graced by the likes of Bill Clinton, Naomi Campbell, Elton John, David Beckham, and Angelina Jolie sporting a milk moustache, the campaign garnered wide recognition. Yet milk was losing favour against a growing variety of breakfast and drink […]
Bernard Merkel: U-turn on the European Commission’s health portfolio still leaves unfinished business
It is not often that an issue about how the European Commission is organised in relation to a specific part of its work on health comes to the top of the political agenda. Yet that is exactly what has happened in the past month. On 10 September, the president elect of the European Commission, Jean-Claude […]
David Zigmond: NHS stewardship—the missing personal factor
In healthcare our systems of governance are increasingly developed and vaunted. Yet these are very different from our capacities for stewardship. Inevitably and predictably, the recent party political conferences each designated the NHS as a crucial battleground: each claimed the better vision, ethos, and competence. Yet there is something recurrently missed by politicians, planners, and […]
Philip van der Wees: Patient preferences to distinguish between good and bad practice variation
“Keeping good practice variation and reducing bad practice variation is a main driver for quality improvement in healthcare.” With this key message, Albert Mulley, professor at the Dartmouth Center for Health Care Delivery Science in the United States, summarized his keynote presentation at the fourth conference of the Scientific Institute for Quality of Healthcare at […]
Julie Browne: Why do some clinical supervisors become bullies?
The literature on bullying in the medical workplace makes disturbing reading. In the General Medical Council’s 2013 national training survey, 13.2% of respondents said that they had been victims of bullying and harassment in their posts, nearly one in five had seen someone else being bullied or harassed, and over a quarter had experienced “undermining” […]
Richard Smith: Leapfrogging to universal health coverage
Low and middle income countries have the chance to create health systems that will perform much better than those in high income countries. Copying health systems that look increasingly unsustainable would not be wise. Instead, low and middle income countries can “leapfrog” to something better, and the World Economic Forum has a project to make […]
Tara Lamont: On biography, cancer, and Richard Doll
I’m a sucker for the lives of great men (and, occasionally, women) in medicine. This is particularly the case when it comes to those who lived in the 20th century, whose lives are punctuated with big moments: from the great depression, to active service overseas in the second world war, to the formation of the NHS shortly after. […]