Dialysis treatment for end stage kidney disease is a burden on patients, taxpayers, and the environment. The carbon cost of dialysis is estimated to be seven tonnes CO2 equivalents per year. Although we can make the improvements to reduce this, the ideal is to prevent people from reaching end stage kidney disease. Traditional systems of […]
Jim Murray: The EU, transparency, and access to clinical trial results
How is the EU involved in transparency and access to clinical trial results? Many readers will know this already, but perhaps not all. For obvious reasons, health professionals have tended to focus on the national and they might not all appreciate the strength of the “side-wind” blowing from the EU. The EU was formed on […]
Richard Smith: Does it take an earthquake to reform healthcare?
Integrating the fractured and fractious components of health and social care systems seems to be everybody’s current favoured “solution” for healthcare problems, but it’s hard to make happen. We now have evidence that it may literally take an earthquake or some other natural disaster to make it happen. Conceptually it’s easy to see why integration […]
Michel Kazatchkine: Aids—huge progress but time for a rethink on how to end the epidemic for those most affected
The progress made against AIDS in the last decade has been extraordinary. In the last decade, close to 10 million people in developing countries have been given antiretroviral treatment. In sub-Saharan Africa, 60% of people in urgent need of such medicines now have access to them, something unthinkable just a few years ago. As a […]
Edward Davies: What’s the point of all this? Existential angst at the AAMC
What’s the point of all this? I ask not as a suicidal prelude or remark of self-indulgent philosophy, but after two days at the Association of American Medical Colleges (AAMC) annual meeting in Philadelphia, I am finding myself asking, what is our endgame here? As conference delegates, as academics, as doctors, as a research journal—what’s […]
Gabriel Scally: A grotesque parody of fairness
It’s a long way to go from Bristol to Boston for a conference, but I’m adding to my carbon footprint and attending the 141st American Public Health association meeting. It’s an enormous meeting. Despite some tough times in the US local public health departments, 13 000 people are making this meeting, yet again, the biggest […]
Ingrid van Beek: Navigating the urban policy jungle—some dos and don’ts
The past 20 years has seen an increasing commitment to evidence based medicine. This approach has also started to inform public policy making. This more objective way of determining the best method forward is especially important in the potentially controversial field of illicit drugs, which has both public health and public order implications. There is […]
Richard Lehman’s journal review—4 November 2013
JAMA Intern Med 28 Oct 2013 Vol 173 1770 There is very little in the journals this week: JAMA is taking a week off and even JAMA Intern Med has thin pickings. Two trials tell us what we expected. It’s a very obvious fact that poorly educated black women in the USA are often obese. […]
William Cayley: Can you show that you care?
“Can’t I just fake it? Can’t I pretend to care, even if I don’t.” So an anonymous physician is reported to have responded during a workshop on caring communication with patients. My colleagues and I all scoffed with appropriate indignation when this story was told, as the same training was presented to us—but I’ve started […]
Keir Arran: A remote and rural foundation programme—a unique experience
Several recent publications, including the BMA’s Healthcare in a rural setting suggest that there is a shortage of doctors working in rural areas. I first heard about the N10 rural track foundation programme from a registrar working in A&E when I was a student. He talked about the programme with such enthusiasm that I looked […]