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Cordelia Galgut: Emotional support through breast cancer

30 Oct, 14 | by BMJ

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Before being diagnosed with primary breast cancer myself, aged 49 in 2004, I would offer emotional support to women with this diagnosis, and arrogantly assume I understood pretty well what they were going through, at all stages—and my then clients were too polite to tell me to the contrary. Little did I know! Life on the other side of the breast cancer divide, as a patient, not a psychologist, differed hugely from how I understood it to be. For a start, it was a much more harrowing, long drawn out process, both physically and psychologically, than I could ever have imagined. It challenged my sense of myself as a woman much more than I could ever have foreseen, to say nothing of my theoretical beliefs as a psychologist. Indeed, I still suffer breast cancer’s fallout 10 years on. more…

Suzie Bailey: Strategy development – starring role or chorus line?

30 Oct, 14 | by BMJ

Suzie-BaileyIs “transformation” one of the most overused words in relation to the NHS and the issues it faces? Just last week, I heard a NHS deputy CEO joke that the word should be banned, and thought I’d happily join him! On the other-hand, “strategic development” is rarely mentioned. This is strange, as isn’t the NHS going to need to do more of both to overcome its quality, demand, and financial challenges?

The Five Year Forward View echoes this sentiment, that strategy is a vital part of the NHS. So, if strategic development has a starring role in helping the NHS’s clinically and financial sustainability—whose job is it?

more…

The BMJ Today: Leapfrogging—the new buzzword in healthcare

30 Oct, 14 | by BMJ

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It is easy to take universal health coverage for granted if you were born and raised in a European country, for example. But in low and middle income countries, people often have to somehow find the means to pay out of pocket for their healthcare, regardless of the availability of quality healthcare. Costs can quickly escalate to astronomical figures in case of serious health problems, and if people don’t have the financial means or relatives overseas who can help, they may end up not receiving any care at all or incurring unmanageable debt. more…

Sarah Knowles et al: Hacking into health research

29 Oct, 14 | by BMJ

Patients get called a lot of things these days. Simon Stevens, for example, referred to them as the “renewable energy” of health services. The NHS White Paper called them “the heart” of the NHS. We at PRIMER (the Primary care Research in Manchester Engagement Resource), however, decided to call them hackers.

More specifically, we invited patients to “be” hackers—to hack into health research by pitching their own ideas for new research projects. The format was borrowed from the existing NHS Hack Days (wonderfully subtitled as “geeks who love the NHS”), which bring together tech experts, such as programmers and developers, with medical experts, doctors, and nurses to work together on new tech ideas that would improve some aspect of healthcare. more…

William Cayley: Overdiagnosis, uncertainty, and epistemology

29 Oct, 14 | by BMJ

bill_cayley_2Many thanks to Anita Jain for reporting on the “Overdiagnosis” session at the Cochrane Colloquium—I wish I could have been there.

The suspicion that overdiagnosis (or at least over testing) is driven in part by the quest for certainty, is corroborated by an implementation study of the Vancouver chest pain rule. When the Vancouver chest pain rule was implemented as a triage protocol, the number of patients presenting for emergency care of acute chest pain who could subsequently be discharged early for outpatient follow-up was almost doubled. more…

The BMJ Today: Is milk good for you?

29 Oct, 14 | by BMJ

America’s iconic “Got Milk?” campaign was pulled this year after a successful run of over 20 years. Graced by the likes of Bill Clinton, Naomi Campbell, Elton John, David Beckham, and Angelina Jolie sporting a milk moustache, the campaign garnered wide recognition. Yet milk was losing favour against a growing variety of breakfast and drink options. The dairy industry therefore opted for a different positioning. Under the tagline “Milk Life,” the ads now tout the richness of milk’s protein content.

The evidence, though, on the health benefits of milk consumption is scant and divided. more…

Bernard Merkel: U-turn on the European Commission’s health portfolio still leaves unfinished business

29 Oct, 14 | by BMJ

bernard_merkelIt is not often that an issue about how the European Commission is organised in relation to a specific part of its work on health comes to the top of the political agenda. Yet that is exactly what has happened in the past month.

On 10 September, the president elect of the European Commission, Jean-Claude Juncker, announced his new team of commissioners and their job portfolios. Among the raft of proposals he made, one change stood out for the Brussels health community: responsibility for pharmaceuticals and medical technology would be transferred from the incoming health commissioner (Vytenis Andriukaitis, an ex-health minister of Lithuania) to the new Polish commissioner responsible for the single market, industry, and enterprise (Elżbieta Bieńkowska). more…

David Zigmond: NHS stewardship—the missing personal factor

28 Oct, 14 | by BMJ

david_zigmond2In healthcare our systems of governance are increasingly developed and vaunted. Yet these are very different from our capacities for stewardship.

Inevitably and predictably, the recent party political conferences each designated the NHS as a crucial battleground: each claimed the better vision, ethos, and competence. Yet there is something recurrently missed by politicians, planners, and orbiting think tanks. It is the crux of personal attitudes, relationships, and investments: the human conductors of our best personal continuity of care. more…

Philip van der Wees: Patient preferences to distinguish between good and bad practice variation

28 Oct, 14 | by BMJ

Philip van der Wees“Keeping good practice variation and reducing bad practice variation is a main driver for quality improvement in healthcare.” With this key message, Albert Mulley, professor at the Dartmouth Center for Health Care Delivery Science in the United States, summarized his keynote presentation at the fourth conference of the Scientific Institute for Quality of Healthcare at Radboud University Medical Center. His message revealed an essential dilemma, in assessing the quality of patient centered healthcare at the individual patient level, versus quality assessment at the healthcare system level. more…

Julie Browne: Why do some clinical supervisors become bullies?

28 Oct, 14 | by BMJ

Julie BrowneThe literature on bullying in the medical workplace makes disturbing reading. In the General Medical Council’s 2013 national training survey, 13.2% of respondents said that they had been victims of bullying and harassment in their posts, nearly one in five had seen someone else being bullied or harassed, and over a quarter had experienced “undermining” (unfair or belittling treatment). more…

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