Health, as we all know but are inclined to forget, is driven not by healthcare but by social determinants. But how do you produce social determinants that promote rather than undermine health? Political action is one way, but another is to strengthen communities. Jennifer Miller, chief executive of the Global Climate and Health Alliance, described […]
The purpose of drug regulatory institutions should be to safeguard the best interests of the patient and to drive patient centred healthcare worldwide. Consequently, improving public awareness and providing information and education on the subjects that matter to patients must be the foundation of strong regulatory regimes, so that they’re on track to keep treatments that work available […]
A 40 year old man has a cough—but his GP cannot find out the cause. Eventually the patient is referred to the local hospital where he is diagnosed with asthma. The doctor who sees him starts inhalers. But the inhalers don’t work and so he goes back for another appointment. The next doctor that he […]
Richard Smith visited and wrote about the NHS in Dumfries and Galloway in 1980, 1990, and 1999, and this series of blogs describes what he found in 2016. A feature article provides a summary. Accident and emergency is a pressure point in many hospitals with rising attendances leading to failure to meet the four-hour target […]
I consider myself a global citizen. My country of birth is different to my nationality on my passport, which again is different to its place of issue, which again is different to where I currently reside. I have resident visas for five countries across three continents and currently, I am a foundation doctor working in […]
In the face of chronic non-communicable diseases, the mantra goes, prevention is better than cure. If we know what causes disease, and if we can prevent its risk factors, we would soon not need most of its treatments. As two academics working in an area where causative factors of complex diseases are often not well […]
The Evidence Based Medicine Manifesto (EBM manifesto) has been launched to improve the implementation of evidence based interventions by pulling together a clear set of achievable goals, and a strong overview of the strategies that work best, to help deliver change better and faster. In some areas, such as the treatment of illicit drugs related […]
Richard Smith visited and wrote about the NHS in Dumfries and Galloway in 1980, 1990, and 1999, and this series of blogs describes what he found in 2016. A feature article provides a summary. The thing that currently pleases Angus Cameron, the medical director of the Dumfries and Galloway Health Board, is that the board […]
Every decision, both in life and in medicine, involves a balance of risk: the decision to go on holiday balances the risk of travelling to and staying in a foreign country against the benefit of a fortnight’s sunshine and relaxation; the decision to treat bacterial pneumonia balances the risk of anaphylaxis against the benefit of […]
Did the Women’s March on Washington, across the US, and in major cities around the world have anything to do with medical care? Yes and no. I’ve lived and worked in Washington, DC for more than 30 years, and I’ve seen a lot of demonstrations, and participated in a fair number as well. But I’ve […]