Recently I saw a patient who has problems with use of multiple recreational drugs and alcohol. The patient had never seen a psychiatrist before, but has been taking an antidepressant for the past few years. This is prescribed by a hospital physician. I almost never prescribe medications outside a psychiatric remit, but antidepressants are regularly prescribed by doctors whose area of expertise is not psychiatry. GPs, ITUs and stroke wards often start their patients on these medications, and hospital physicians can also be very fond of them. more…

I associate camps with wood smoke, burnt sausages, and filled latrines marked with crosses, but HealthCamp is different. It’s about innovation, and I attended my first one last week—at the soulless Excel Centre in Docklands, LondonHeathCamp begins with lightning talks. In under two minutes participants must pose one problem they’d like to discuss. We had 21 people—many of them doctors, most of them young, and all of them entrepreneurs—pose problems. more…

Richard fancied a change, so is currently blogging on BMJ Group’s new professional networking site for doctors, doc2doc. You can read his weekly journal watch blog there.  This week he turns his attention to gene gnomes, finds the Lancet a bit waffly and the New England Journal of Medicine in self congratulatory mode. To comment on his blog, you will need to login or register.

The Student BMJ is asking, via Twitter, for accounts of people’s first days as a doctor, and their request has for me brought back painful and partially suppressed memories. I started in the Eastern General in Edinburgh on Sunday 1 August 1976 and experienced my first death from medical error on the Monday. Maybe this explains the rest of my career—as an editor and busybody, rather than practising doctor. more…

Training to be a clinician is so much more than simply accumulating facts. It is easy to forget, for example, just how much time and energy we spend on learning to use our senses. Despite having served the owner well for 18 or more years, the senses of the “raw” student still need much honing if they are to be used as part of medicine, and learning to use them is very revealing. more…

The spread of A/H1N1 flu has propelled Margaret Chan, director general of the World Health Organization, into the limelight. On 11 June she was on television and radio programmes across the world, declaring that “the world is now at the start of the 2009 influenza pandemic” and that “further spread is considered inevitable”  more…

Democracy means involvement in decision making but it may not always lead to the best outcomes. With this simple analogy, Gerd Gigerenzer (Berlin), captured the potential hazards of clinical shared decision making in his keynote address to the 5th International Shared Decision Making Conference in Boston (June 14-17). more…

 
If there was a pill that would improve your interaction with patients by 50% would you take it? I imagine you would. Well, I don’t know of such pill and can’t think that there will ever be such a thing, but there is a non-pharmacological way to improve you consulting—it’s called “values based practice.” To be honest, I don’t know that it will improve your skills by 50%: it might be less or more, but I’m confident that it could help you. more…

Richard is in Prufrockian mood as he picks out items of interest in the latest major medical journals. As well as quoting T S Eliot, he also pens his own ditty about a zika virus outbreak on the island of Yap. more…

Older readers will remember when the Medical Defence Union had a telegraphic address – Damocles. Younger readers may not know that he was another of those Greek mythological characters to whom the gods or their employers gave a tough time – in his case suspending a sword over his head by a single hair. Oh, and a telegraphic address is what you sent telegrams too. And telegrams were a sort of hard copy Twitter. more…