At a recent meeting in Washington State an attender denounced the evils of The Affordable Care Act (ACA), or as it has become known “Obamacare.” He argued that requiring compulsory health insurance was a major restriction of personal liberty. When I asked what should happen to someone who becomes ill but does not have any […]
Desmond O’Neill: Aiming to lose
Working as a doctor in Ireland has many positive aspects, particularly a warm human ambience and a remarkable love of the spoken word. On the debit side of the linguistic largesse is a leaning to the elliptical and the discursive, and a generalised tendency to soften the hard blows of life. A prime example of […]
Richard Smith: A bad bad week for access
I was once the editor of the BMJ and chief executive of the BMJ Publishing Group. I work for a $100 billion company. I’m an unpaid professor at both Warwick University and Imperial College London. But, mighty and pretentious as this sounds, I’m down there in the gutter when it comes to accessing scientific articles, […]
Edzard Ernst: The “integrated medicine” straw-man
Proponents of integrated medicine want us to believe that they are offering “the best of both worlds” to their patients and claim that using a combination of alternative plus conventional medicine is preferable to conventional medicine alone. This approach allegedly extends our therapeutic options, respects patient choice, and provides compassion in healthcare. Alternative practitioners, they […]
Andrew Brunskill: The strike zone—nothing to do with pensions in the USA
Doctors don’t strike about employee pensions in the USA. This is because many of them are not employees and few have defined pensions from the employers. Most doctors are in defined contribution schemes. Defined contribution means that the employer contributes to an investment fund (which will include some combination of bonds or equities with additional […]
Domhnall MacAuley: Storm clouds and research
On an island off the west coast of Ireland, I picked up a discarded newspaper while sheltering in a bar. Browsing through, I came across an article about physical activity and depression. Based on a BMJ paper—a randomised controlled trial on promoting activity in depressed patients—it discussed the findings at length. A few days off […]
Richard Smith: What I learnt about non-communicable disease in one afternoon
Most of my work is concerned with non-communicable disease (NCD) in low and middle income countries, so I’ve got to know a fair bit about the subject. But yesterday I spent an afternoon at Imperial College listening to a series of short presentations on NCD in low middle income countries (LMIC), and I learnt a […]
Pritpal S Tamber: Evidence and the real world
There is a lot of angst around why research evidence takes so long to penetrate routine clinical practice. My view is that it’s a miracle that any of it makes it into practice at all because research derived information is very much the square peg to clinical practice’s round hole. The gold standard of experimental […]
Martin McShane: Walk the talk
Sometimes, it becomes apparent that what we have been talking about for so long is actually beginning to happen. Over the last few weeks we have been preparing for our Annual Accountability Review with the SHA. We have had our monthly cluster board meeting. We also had a meeting with the acute trust, looking at […]
Tracey Koehlmoos: Implementation research evidence uptake and use for policy making
For the last two years I have worked on a project about implementation research with more than 120 colleagues from across the globe: India, Chile, Mexico, Switzerland, Brazil, Canada, Uganda and more. The book, which was published by the World Health Organization (WHO) and the lesser known TDR is called Implementation research for the control […]