Back when Christian Jessen of Embarrassing Bodies fame was training as a junior doctor, he regularly worked dangerously long hours. But then in August 2009 the European Working Time Directive (EWTD) was introduced to limit the working hours of doctors to 48 hours a week. Problem solved.

But of course nothing is ever that simple, as Jessen discovered in his Channel 4 Dispatches investigation on junior doctors’ hours. Despite the regulations, doctors up and down the country are still working in excess of 100 hours a week. more…

Last year a colleague phoned a patient named in a BMJ practice article. The patient had consented to her story being published (it was about to go live), but had wrongly thought her account was destined for publication in an obscure medical journal that would gather dust on library shelves.

My colleague was concerned that the patient might not realise that because bmj.com is well optimised for search engines, her name and details might appear high up in a list of Google results for years to come. It would also be seen by the BMJ’s 120 000 print subscribers, and those with access to the journal’s iPad app. Instead the woman opted to have her first person account anonymised, so she could not be identified. more…

The recent 2013 Selling Sickness conference in Washington, DC was chock full of fascinating speakers. In an earlier blog I discussed my participation in a panel discussion at the conference, and Rachel Hendrick has also blogged about the meeting. It was difficult to choose from the topics on offer during the two day gathering, and many of the most enticing talks seemed to be scheduled concurrently with others that were equally intriguing. Since there were so many speakers and topics at the meeting who deserve attention, here are some selected highlights from my notes with links to more information about their work: more…

The 29th annual TED Conference in Long Beach, California, started as I remember several previous TEDs began: with two men with newly published books to sell proposing a future that was going to be either terrible or terrific. (The Economist ran this debate with the same protagonists on 12 January.) Since this was futurology, based on selective quotation of currently available data, there was no knockdown winner.

Still, later in the meeting, some pessimistic notes were struck that made you sit up and listen. Danny Hillis, computer guru, wondered whether too little attention had been paid to defending the internet itself. It’s vulnerable to mistakes and deliberate attacks; there are “a lot of bad guys out there.” We need a Plan B if and when it gets taken down, argued Hillis. Vint Cerf, “father of the internet,” thought that the internet would probably pull through. He’s proposed “clean sheet”—rethinking the internet as if it had never been built, and seeing whether any new ideas could be retrofitted into the existing architecture. more…

It would be hard to collect a more fascinating bunch of topics or people in a hotel conference room. The 2013 Selling Sickness conference recently held in Washington, DC was among the most thought provoking and just plain interesting conferences I’ve been to in a long while, and I go to a lot of conferences. This third conference in a string of international conferences (Newcastle, Australia, 2006 and Amsterdam, 2010) was characterised by its organizers as part of “a global reform movement” against the “marketization of health, the corporatization of healthcare, and the hijacking of patient and consumer language to disguise market interests.” Opening speaker Shannon Brownlee identified “the different heads of the hydra” as “disease-mongering, conflict of interest, and overdiagnosis.” In her view, the challenge of this meeting was to identify these aspects of selling sickness and “weave them together in a systemic movement that promotes systemic changes.” more…

On Monday, a friend posted a picture of an enormous, triple layered chocolate cake on Facebook. It was, she wrote, a present for her boyfriend—a final year medical student—to celebrate his being awarded his top choice of location for his first job next year. Getting the first choice has meaning beyond simple preference: it enables the couple to spend the next two years living in the same part of the country.

But the elation and the chocolate cake were soon followed by sadness and anger. As you will have heard by now, the job allocation process is to be rerun, and, like thousands of other final year medical students, my friend’s boyfriend has no idea whether he will achieve the tantalisingly glimpsed first choice job again. more…

Sir David Nicholson, head of the NHS in England and chief executive of the NHS Commissioning Board, has faced repeated calls for his resignation after publication of the Francis Report inquiry into failing at Mid Staffordshire Foundation NHS Trust. Nicholson was chief executive of the strategic health authority overseeing the trust for a period when death rates were found to be high. more…

Coinciding with the visit of the British prime minister, David Cameron, to India last week, a business seminar was held in Mumbai to identify opportunities for health sector partnerships.

Meeta Lochan, secretary of the public health department of Maharashtra, offered insights on the intricacies of healthcare provisioning in Maharashtra. For instance, over the years the government has invested substantially in building health facilities so that nearly 60% of beds at the tertiary care level are now in the public health sector. However, less than 25% of doctors and medical equipment are in the public sector. Lack of data on the health outcomes of these investments further prevents effective planning for the future. To set standards for the quality of care in the nation, the Clinical Establishments (Registration and Regulation) Act came into force in 2010. However, implementation of the act has been sparse and very few states have adopted it so far. more…

Last week a BMJ investigation reported that one of the world’s leading producers of diagnostic tests has been falsely marketing one of their products. Oxoid, owned by US diagnostics giant Thermo Fisher, has been selling antimicrobial susceptibility test (AST) discs that do not always contain the advertised amount of antibiotic.

The $10bn a year company’s website claims that it is “renowned for quality, accuracy, reliability and innovation.” However, internal documents seen by the BMJ show that this reputation may not be entirely justified. more…

When a politician speaks with passion and commitment about social inequality, I listen. When it is the chairperson of the Committee for Health, Social Services, and Public Safety, I listen carefully. Our practice is in an area internationally recognised as socially deprived, and, if politicians took a genuine interest and were prepared to invest resources, it could transform healthcare and improve the lives of so many people. Recently, the chair and deputy chair visited Cuba and, like many before them, were greatly impressed by the Cuban health system where they achieve impressive outcomes with services based very much on the family doctor. more…