The machinations behind the current attempt to defund Obamacare are politically complicated and have a prelude several years long. The evolving story on the federal budget and the rights and wrongs of both it and the Affordable Care Act are well covered elsewhere, but as I type this Senator Ted Cruz is entering the 20th […]
Desmond O’Neill: Striking doctors and a cruel cut
The strike was so much more straightforward in 1987. I was then a trainee member of the Council of the Irish Medical Organization and our task was to change an overtime rate of half of the hourly rate to one of at least time and a quarter, thereby removing the employer incentive for virtually limitless […]
Isabella Laws: Innovative teaching—why hasn’t it come further?
Medical education has long seen the need for reform. The aged style of listening to a lecturer impart hours worth of highly technical scientific information at a rate which sees you frantically scrawling everything down on a page continues to cling on, despite the fact that it is outdated. For one, lecture notes are available […]
Unni Karunakara: Médecins Sans Frontières’s decision to pull out of Somalia
Médecins Sans Frontières’s announcement on 14 August that we were closing all our medical programmes in Somalia sent shockwaves through political and humanitarian communities. It came at a time when world leaders, for the first time in decades, were beginning to make positive noises about a country on the road to recovery and with a stable […]
Hazim Sadideen: Are surgical experts born or made?
There have been increasing levels of research around the concept of surgical expertise and its development. It’s an intriguing debate, a greater understanding of which will help to drive professional standards and quality of patient care. As pressure on surgeons intensifies due to funding cuts, growing caseloads, and shorter working weeks, the drive to improve […]
Richard Smith: Medical journals: “a colossal problem of quality”
We knew that we had “a colossal problem of quality” when we began the peer review congresses in 1989, said Drummond Rennie, creator of the congresses, at the seventh congress in Chicago earlier this month. That problem is now better described and defined, in large part because of the congresses, but it’s even bigger than […]
Tiago Villanueva: How can doctors avoid becoming deskilled whilst working in non-clinical roles?
My main concern about working in a fulltime non-clinical position is becoming a less competent doctor by the time I start to see patients again (whenever and wherever that is). Doctors need to continually see patients and to regularly study and manage their own needs of Continuous Medical Education (CME) to avoid becoming deskilled, particularly […]
Vasiliy Vlassov: The Russian government tries to reduce hospitalisation rates
It is well known that the USSR and modern Russia have a significantly higher number of hospital beds compared to other European countries (1 225 370 hospital beds: 143 347 059 per capita, or 855 beds per 100 000 capita in Russia vs 504 hospital beds in old members of the EU). The Russian government […]
Tracey Koehlmoos: Life without health insurance in the US
If you are a UK citizen, you probably think we are barbarians. Go ahead and say it, “How can you be a wealthy nation spending so much on healthcare and everyone does not have the right to go to the doctor when they are sick?” I hear this all the time. However, the wheels of […]
Richard Lehman’s journal review—23 September 2013
NEJM 19 Sep 2013 Vol 369 1106 I’m starting with the second paper about colonic cancer screening in this week’s New England Journal of Medicine, because it takes us to one of the places where it first began: the state of Minnesota. Up there, just under Canada and just west of the Great Lakes, 46,551 […]