In 1986 the World Health Organisation held the first global conference on health promotion at which the Ottawa Charter for Health Promotion was drafted and adopted. It has become the bible for health promoters with its five strategies of building healthy public policy, creating a supportive environment, strengthening community action, promoting individual skills and re-orienting […]
Richard Smith: How often do men think about sex?
Everybody knows that men think about sex every seven seconds. What people haven’t perhaps considered is that means more than 8000 times a day or 56 000 times a week. Despite the joke that if men only think about sex every seven seconds what on earth do they think about the rest of the time, […]
Readers’ editor: Abbreviations and patient safety
In January this year a hospital pharmacist contacted us after a colleague had questioned a prescription for amlodipine 10 mg four times a day for migraine. She contacted the prescriber, who said he had got the dose from this clinical review about pharmacological prevention of migraine published in The BMJ. […]
David Zigmond: Hello, health commissioner. Goodbye, family doctor?
In this new era of GP led NHS commissioning, I saw a young GP on the television. She was interviewed to sample a voice of professional support and enthusiasm for the reformed regime. She spoke with an authoritatively quiet manner and an assured economy of phrase. She said: “GPs know their patients, families, and neighbourhoods.” […]
Domhnall MacAuley: General practice and social deprivation
A single naked bulb lights the room. Clothes hang over the radiator, there is a cot by the door, and a huge TV in the corner. Just a few worn chairs and a clapped out couch. Feet stick to the carpet. A world worn 19 year old and a distraught infant; hot, flushed, and dribbling. […]
Deborah Kirklin: Mid Staffs—would you have been a whistleblower?
The latest Medical Humanities poll asks readers a simple but searching question: if you witnessed unaddressed failings in local healthcare provision, would you feel confident and secure enough to whistle blow? Inspired by a series of on-going scandals about the care, or rather lack thereof, provided to some NHS patients, the poll is linked to […]
Edward Davies: Pharma is changing. Can doctors say the same?
About 13 years ago I attended my first US mega meeting of doctors. I was there for a research agency, working on behalf of a large well known pharmaceutical company, analysing their marketing campaign for a new drug. From the moment I got off the plane, I was slapped into brutal submission by the advertising […]
Charlotte Elder: A call for a bit of honesty
Before a career move to paediatrics I was a GP trainee. Whilst brainstorming what topics we were going to cover in our VTS half day release, I suggested that we develop our skills as reflective practitioners and discuss our imperfections as doctors. It would be a chance to talk about ourselves as fallible humans who […]
Edward Davies: The big bang meeting vs peer review
In the world of oncology, and indeed the world in general, meetings don’t come bigger than that of the American Society for Clinical Oncology. I hesitate to quote a cab driver as a source of fact, but the one I met at Chicago airport told me more than 30,000 delegates were coming through the city […]
William Cayley: Are we getting too systematic for our own good?
“We need to standardize our systems of practice to improve our quality metrics and do a better job of caring for our patients.” Such was the thrust of a recent management meeting, yet it left me wondering whether or not we are headed in the right direction. Increased public reporting of quality “metrics,” focus on […]