“You saved my life, doctor. I can’t thank you enough.” Letter from Tom 2011 “Our mother is dead … because of you.” Bereaved daughter. Poplar coroner’s court 2010 “What is the drug you use with patients all the time?” “The doctor is the drug.” M Balint 1952 [1] Professional identity is particularly strong in doctors […]
The BMJ Today: Paying people to live healthier lives and tackling climate change
This week, the Intergovernmental Panel on Climate Change (IPCC) released its Fifth Assessment Report. The scientists who wrote it warn of the serious impact that climate change—unequivocally influenced by human activity—will have on humans and other species in the planet. The IPCC calls for world leaders and policy makers to promote adaptation strategies to mitigate […]
Nathan Sivagananathan: Trail—improving cancer care in Sri Lanka
In 2011 Nathan Sivagananathan and Sarinda Unamboowe set out to transform the lives of patients with cancer in the northern region of Sri Lanka. For over three decades the northern territory has been in the throes of terrorism, with little room for economic or social development. The ongoing war made the 400 km journey to […]
The BMJ Today: Vitamin D, probiotics, and polio
We have been longing for a final word on whether vitamin D supplements improve health. An umbrella review published today included 107 systematic literature reviews and 74 meta-analyses of observational studies looking at serum levels of vitamin D, as well as 87 meta-analyses of randomised trials testing vitamin D supplements. A total of 137 outcomes […]
Gavin Yamey: Soldiers, academics, and an unusual health initiative
It’s not every day that you find yourself at a work meeting chatting to a soldier who led the Counterinsurgency Advisory and Assistance Team in Afghanistan and the doctor who directed the largest global health initiative in human history. Retired US Army Colonel Joseph Felter is now a Stanford University academic with expertise in studying […]
The BMJ Today: Selective decontamination revisited and healthcare reform in Massachusetts
Richard Price and co-workers published a network meta analysis evaluating the effect on mortality of selective digestive decontamination (SDD), selective oropharyngeal decontamination (SOD), and topical oropharyngeal chlorhexidine in patients in general intensive care units. They found that both SDD and SOD confer a mortality benefit when compared with chlorhexidine. […]
Ryan Irwin: What healthcare can learn from football—10 key lessons
Football, the world’s most played sport, provides an excellent laboratory for understanding the nature of organisations and has some useful lessons for members of the healthcare economy. Here, 10 lessons are explored. 1. Culture is king Culture is the product of values, beliefs, and behaviours. Football clubs are synonymous with their own cultures, which when […]
Sarah Gregory: What can we learn from how other countries fund health and social care?
England is not alone in facing the implications of an ageing population with changing patterns of illness. To inform the work of the independent commission on the future of health and social care in England, I have spent the past few months looking at how other countries are responding to these challenges. By comparison with […]
The BMJ Today: Debates about alternative medicine and cancer screening
People love complementary and alternative therapies, and vote with their wallets to spend close to £5 billion a year in the UK alone on treatments such as massage, relaxation, evening primrose oil, and reflexology. Doctors may be more or less comfortable with these therapeutic choices, but we should all be trained to deal with them […]
Richard Lehman’s journal review—31 March 2014
NEJM 27 Mar 2014 Vol 370 1189 I sing the body mitotic: we are a mass of cells dividing, mutating, cannibalizing, spreading. The wonder is not that we ever die of cancer, but that we often don’t. Cells which become aggressive are extraordinarily versatile at remaining aggressive, as shown by the relatively rare ALK-Rearranged Non–Small-Cell […]