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Philip Wilson: 10 years of change in medicine

26 Nov, 13 | by BMJ

Philip WilsonBMJ Learning is celebrating its 10th anniversary this year, and we wanted to do something special to mark the occasion. As we talked over ideas, we kept coming back to the theme of 10 years, and how much medicine had changed during that time.

HIV has gone from being a terminal illness to a chronic disease, with smaller and smaller effects on life expectancy. More people are surviving cancer, and facing the prospect of living longer with the adverse effects of their treatment. Antibiotic resistance and hospital acquired infections have become hot political topics, discussed in tabloid newspapers as well as medical journals.

Could we get a group of experts to sum up the changes in their field in a concise, engaging way? Our users keep asking us for shorter chunks of learning, so could our experts limit themselves to 10 minutes? We started filming the interviews, and ended up doing 10 of them. I’m worried we’ve become a little obsessed with the number 10.

The idea that patients should be at the heart of healthcare systems has gained currency in recent years, and Neil Churchill—director for patient experience at NHS England—told us how engaged patients are much more likely to heed their doctor’s advice. There’s even research linking perceived empathy from healthcare professionals to improved clinical outcomes. Neil summed up by saying it’s vital to see care from the patient’s point of view.

Theresa Wiseman—strategic lead for health service research at the Royal Marsden NHS Foundation Trust—talked about how improved five year survival among cancer patients has led to a need for new approaches in oncology. After the shock of diagnosis and the intense experience of going through treatment, people can feel abandoned when they start having less contact with their healthcare team. Doctors need to be aware of long term problems such as anxiety, depression, or sexual problems, which may present in primary care a long time after a cancer diagnosis. Like Neil, Theresa emphasised the importance of listening to the patient.

Laura Piddock—professor of microbiology at the School of Immunity and Infection at the University of Birmingham—talked about how the spread of antibiotic resistant bacteria has the potential to undermine all areas of medicine. Methicillin resistant Staphylococcus aureus (MRSA) infections are falling in the UK, probably thanks to improved hygiene and efforts to eradicate Clostridium difficile, but resistant strains of Escherichia coli could fill the gap. Laura told us of the need for new technologies to diagnose and treat infections, and further emphasised the patient angle—the public need to understand when antibiotics shouldn’t be used.

The full course also includes modules on pandemic flu, biological drugs, stroke, vaccination, human papillomavirus vaccination, and statins. The series is completely free until 27 November, after which you’ll need a subscription to BMJ Learning. There’s even a module featuring BMJ Learning’s own Dr Kieran Walsh talking about changes in medical education. We hope to lead the way in online CPD for the next 10 years.

Philip Wilson is head of Online Learning, BMJ Learning.

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