Out with pacey surgical ward rounds; pain controlled, E+D, BO, OE – alert, obs stable, neurovascularly in tact, plan – drain out, fluids down, OT/PT, home when safe, OP 6/52. Out with debates about thromboprophylaxis, clotting and bleeding. Out with preadmission clinics. Out with being the crash team leader – I’ll not be sad to […]
Richard Lehman’s journal review – 6 February 2012
JAMA 1 Feb 2012 Vol 307 467 We of a physicianly disposition may not like to admit it, but throughout history surgeons have been well ahead of physicians at looking critically at their outcomes. For example, rates of re-operation have appeared in case series reports for well over a hundred years, so this paper on […]
Domhnall MacAuley: Stress, morale, and compassion fatigue
Another part time middle aged GP. Another almost apologetic explanation. Another slightly embarrassed colleague. Why is it that so many GPs in their prime seem to be going part time, retiring, or changing direction? This was a generation who selected general practice as their first choice career. They aspired, not to a specialist training, but […]
Rachel ter Horst: The tomorrow of neglected tropical diseases
Four acts in 90 minutes. A tight script that does not leave time for clapping. Nine men in dark suits and one woman on stage. That one woman is Margaret Chan, Director General of WHO. One of the men is Bill Gates. The stage is Uniting to Combat Neglected Tropical Diseases (NTDs), an event convened […]
Peter Lapsley: I know my place
Hraztan Jebejian is an Armenian doctor, and a very good one. He studied hard, keeps his CPD up-to-date, ensuring that he is fully abreast of developments in his speciality, is utterly reliable, and much in demand. He works very hard and makes a good living. […]
COMET team: BRAVO for breast reconstruction
Women considering breast reconstruction after mastectomy for cancer face a myriad of choices. They need to decide if and when to have a reconstruction and which of the different procedures best suits their needs. To facilitate such complex and personal choices, women require information about previous patients’ experiences of surgery, particularly about cosmesis and psychosocial […]
Domhnall MacAuley: Are you a sports and exercise medicine award winner?
Olympic medals may be presented to individuals—but no one achieves greatness alone. Behind every great sporting success is a team of coaches and support staff that includes doctors, physiotherapists, nutritionists, psychologists, and a range of other experts. […]
Richard Smith: Death festival, day three
I’m up early and off to the death festival for the third day with a very light heart, and we are straight into practicalities. […]
Tiago Villanueva: Do young Portuguese doctors still want to work in Portugal?
About 10 months ago I blogged that an exodus of doctors from Portugal would be a sign of Portugal’s worsening economic situation. Medicine has always offered one of the few stable and prosperous careers. Most doctors are still in employment, and our income levels are usually above the national average as many doctors juggle professional commitments in both the public and […]
Martin McShane: Tipping point
The announcement last week of the design of the NHS Commissioning Board is critically important. It signals the end of the prolonged period of ambiguity which managers have experienced since the white paper was published in July 2010. For those who have been through the round robins of previous reforms there is a realisation that […]