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Domhnall MacAuley

Domhnall MacAuley: On being an editor

17 Jul, 13 | by BMJ Group

Domhnall MacauleyWhy be a medical editor? Pippa Smart, with whom I run a course for medical editors, asked me recently if she could reproduce something I had written. As a strong advocate of open access—free access and unrestricted reuse—I had no hesitation in saying yes. I wrote this paragraph in 2010 to be included in “Why should I be an editor” materials for the Qatar Foundation. See what you think: more…

Domhnall MacAuley: Are there any aspects of healthcare about which you are passionate?

2 Jul, 13 | by BMJ Group

Domhnall MacauleyHealth inequality. As an editor, we see lots of papers on health inequality; an anodyne, antiseptic term that trips off the tongue without baggage. Not much new. But, in practice it means poor people, who may smoke too much, eat the wrong food, don’t have jobs, live in the wrong place, have lots of illness, and die young. When you see patients suffer unnecessarily simply because of an accident of birth, it makes you acutely aware of the gap between the rhetoric and the reality. And doctors who work at the wrong end of social inequality see a very different world where patients have different priorities and more urgent health needs. If your main concern is getting a job, putting food on the table, and managing from day to day, then health promotion, anticipatory healthcare, and self development don’t seem that important. National healthcare priorities are often determined by people with no experience of areas of deprivation, and who focus on priorities at the other end of Maslow’s hierarchy of needs. Self actualisation is worth sod all if you have no job and no future.   more…

Domhnall MacAuley: The US champions primary care

19 Jun, 13 | by BMJ Group

Domhnall MacauleyWhen the US starts to champion primary care, it is time to sit up. With its traditionally specialist focus, this may seem out of character, but as a result of the Patient Protection and Affordable Care Act, there is increasing focus on family medicine. In a perspectives article last year in the NEJM, Susan Okies suggested, “The primary care doctor is a rapidly evolving species …. it’s hard to say how primary care physicians will fit into emerging delivery models.” more…

Domhnall MacAuley: Unintended misconduct identified in research

14 Jun, 13 | by BMJ

Domhnall MacauleyTwo recent stories provoked a fascinating discussion on misconduct in research—that have nothing to do with the authors, and in the most unlikely of journals. The May 15th edition of the Journal of Applied Physiology explored these two cases in detail. There was no suggestion of research misconduct by the authors, but these controversies introduce a whole new perspective into the ethics of research. Pater Wagner explains what he did in his editorial, “When worlds collide—elite sport, doping, and scientific research.” Take a look at the brief histories below—and see what you think? more…

Domhnall MacAuley: General practice and social deprivation

6 Jun, 13 | by BMJ Group

Domhnall MacauleyA single naked bulb lights the room. Clothes hang over the radiator, there is a cot by the door, and a huge TV in the corner. Just a few worn chairs and a clapped out couch. Feet stick to the carpet. A world worn 19 year old and a distraught infant; hot, flushed, and dribbling. Kneeling in the squelchy dampness, knowing it’s vomit before catching the smell. Earache, temperature, miserable. No soft light movie sentimentality—home visit reality.   more…

Domhnall MacAuley: No magic answer for Achilles tendinopathy

30 May, 13 | by BMJ

Domhnall MacauleyAlthough they are trendy money spinners, best evidence shows little effectiveness”—An attention grabbing subheading to an editorial by Nic Maffulli in the BMJ commenting on an intriguing randomised controlled trial (RCT) from New Zealand on the use of autologus blood injections in treating Achilles tendinopathy. It doesn’t work. more…

Domhnall MacAuley: Designing general practice for others

15 May, 13 | by BMJ

Domhnall MacauleyFlying off to Berne to talk about general practice in the future, I met a GP colleague in the airport. A conversation contrasting theory and reality. Asked to talk to Swiss GPs about the best models of European general practice, with particular focus on the UK, I looked back on the effect of the 2004 GP contract, which was designed to help with poor morale and under payment—and introduced radical new changes with a performance related component to income (Quality and Outcomes Framework—QOF) and major changes to out of hours. more…

Domhnall MacAuley: Pot plants and care homes

9 May, 13 | by BMJ

Domhnall MacauleyI cannot have pot plants in the house. The overwhelming smell of pot plants and stale urine is my lasting memory of visiting residential and nursing homes many years ago as a GP trainee in Devon. Rows of pot plants arranged in the hallway and rows of elderly people in front of the television. This memory is, perhaps unfairly, coloured by my lack of experience and feelings of powerlessness at the time—as an inexperienced trainee I hadn’t seen many older people in the community and I wasn’t sure what to do. These homes were often in adapted older buildings which, despite modification, were probably unsuited for purpose and staffed by nurses displaced from mainstream nursing or washed up in a career cul de sac. I didn’t enjoy it. more…

Domhnall MacAuley: Celebrating clinical teaching in Wales

2 May, 13 | by BMJ

Domhnall MacauleyWe don’t celebrate success enough in medicine. We sometimes mutter, grumble, and gripe, but we seldom congratulate our friends and colleagues on their success. What a pleasure therefore to attend the Welsh Clinical Teacher of the Year Awards in the beautiful Royal Welsh College of Music and Drama. A gala evening of recognition for those who inspire a generation. Most awards are static, contemporary, or retrospective, but while those nominated enjoyed their moment of recognition, their teaching lasts a lifetime—influencing doctors and helping patient care for years to come. more…

Domhnall MacAuley: International Quality Forum, day 3

19 Apr, 13 | by BMJ

Domhnall MacauleyWhen it all goes wrong, that’s when you are really tested. Quantas pilot Captain David Evans described what happened when an engine disintegrated in mid air on Flight QF32 and three large metal shards pierced various parts of the huge A380 aircraft causing major systems failure. Only one of four engines could operate at normal capacity, fuel spilled from the tanks, and the aircraft was severely disabled. Parts of the engine fell on Indonesia, misreported on Twitter as a crash, which immediately made international news headlines, yet the plane was still in the air. The crew stabilised the plane, but still had to land an overweight aircraft at excess speed, with overheating brakes, leaking fuel and, from their calculations, just 139 metres to spare on the runway in Singapore. And, even when they landed, with one engine failing to shut down, there was still a very high risk of fire. The operation was a success—everyone survived. more…

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