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Editors at large

Tiago Villanueva: Family medicine and private health insurance in Portugal

13 Oct, 16 | by BMJ

tiago_villanuevaI read with interest some recent articles about the interplay between private healthcare insurance and state provided healthcare. [1][2][3]

A substantial proportion of the population has private health insurance in Portugal, where I work as a GP. Funding cuts and raised co-payments because of the financial crisis have decreased the appeal of public healthcare, prompting many people to buy private insurance. [4] This grants quicker access, and sometimes with smaller co-payments, than in the public system. more…

Helen Macdonald: Fixing evidence based medicine

11 Oct, 16 | by BMJ

helen_macLove it or hate itwe must all consume evidence. Now is your chance to have your say on what its future should be like. Yesterday the Centre for Evidence Based Medicine at Oxford University launched a new manifesto calling for better evidence for better healthcareThe BMJ team is partnering with them. Writing to launch the manifesto The BMJ says: more…

Elizabeth Loder: Should orange be the new black for price-gouging pharma execs?

31 Aug, 16 | by BMJ


One thing’s for sure: Heather Bresch, the CEO of Mylan Pharmaceuticals, looks good in orange. She’s the subject of a recent New York Times article that opens by declaring “America has a new pharmaceutical villain.” (Martin Shkreli, former CEO of Turing Pharmaceuticals who raised the price of an essential toxoplasmosis drug by 5000%, is the old villain, of course.) The piece describes the public outcry in the US over enormous price rises for the company’s life-saving EpiPen® product. It details the many company activities, overseen by Bresch, which made those increases possible. It’s a sordid, unedifying tale. Bresch is pictured alongside the Times article wearing a stylish orange dress. Judging by the tone of some of the article, it makes you wonder if instead she should be wearing an orange prison jumpsuit? more…

David Payne: Medical stuff at Edinburgh’s festivals 2016

4 Aug, 16 | by BMJ

drahmed02For the first time in more than a decade I’m skipping Edinburgh in August with its international, fringe, and book festivals. It seemed like a good idea at the time. The fringe grows ever more unwieldy, accommodation is scarce and expensive, and I’ve gained a week to explore more destinations in the UK or overseas.

But now I’m feeling a twinge of regret. Two days ago when I overheard a colleague commission a review of Glasgow GP and The BMJ‘s award winning columnist Margaret McCartney, who makes her festival stand-up debut this year.


Deborah Kirkham: Mind the technology gap—how can the NHS bridge it?

20 Jul, 16 | by BMJ

deborah_kirkhamI find the exhibition halls at conferences fascinating. They provide an interface between private and public sector which many clinicians are not exposed to in their day to day work. There’s the private companies with their baristas and artisan coffee beans; a stand that’s bigger than the square footage of an average UK home, and so many lights, screens, and colours, that one can only stand and gaze in wonder. At others, more modest organisations, or perhaps more modest public sector budgets, stretch to a branded tablecloth, a pop-up banner, and a free pen. more…

Rosamund Snow: What makes a real patient?

19 Jul, 16 | by BMJ

rosamund_snowA few years ago I applied for a grant to study my own long term condition. I started out as Ms Snow, ashamed of saying the name of my disease, and ended up Dr Snow, the type 1 diabetic, knowing a lot more about research and academia than I ever thought I would. I realised that patients can see things in research that clinicians can’t because we think to look in new places, and we spot discrepancies that doctors take for granted. I became particularly interested in power relations, and then in the things that stop patients having a say in what gets researched in the first place. more…

Fiona Godlee: My biggest career failure

15 Jul, 16 | by BMJ

fi_blogLike most of us, I have known failure. I tried to get into Cambridge to do preclinical medicine from sixth form—twice: once in my fourth term and again in my seventh. Both attempts were unsuccessful. Instead I went to University College London and got to know London (my favourite city), and had the added benefit of studying history of medicine at the Wellcome Institute. But I did subsequently get to Cambridge for the fourth and fifth years of medical school and I live there now. more…

David Payne: Time to pause Scotland’s “Named Person” policy

16 Jun, 16 | by BMJ

“They fuck you up, your mum and dad. They may not mean to, but they do.” Was Philip Larkin right, and if so, are state-funded parenting classes the answer? Or should we be offering all children, regardless of their background, access to a state guardian from birth to 18 to help safeguard their wellbeing?

One apparent problem, two potential solutions. John Ashton, outgoing president of the UK Faculty of Public Health, told The Times that between 10-15% of school-leavers are in trouble emotionally or mentally, with one child in ten having a mental health problem. more…

David Payne: “Bed blocking” is an offensive term

9 Jun, 16 | by BMJ

older_patient_hospitalSimon Stevens, head of the NHS in England, has warned MPs that delays in releasing older patients from hospital could continue for up to five years because of social care pressures. His comments were immediately reported as a “bed blocking” crisis.

The term bed blocking certainly trips off the tongue more easily than “delayed transfers of care,” but is the term derogatory? I think it is, implying that one patient is somehow denying another access to care. more…

David Payne: Do we still need hospitals (and hospital beds)?

3 Jun, 16 | by BMJ

IMG_0495During a conference coffee break last week two physiotherapists pushed a hospital bed through the networking area, along with a wheelie bin overflowing with “redundant” bed-related paraphernalia—monitors, clipboards, etc.

The hospital where Shanna Bloemen and Yvonne Geurts work plans to remove beds during the day to encourage patients to get active and get out of the wards. Implementation is due to begin in the department of cardiothoracic surgery and will be extended to others over time. more…

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