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Frank Chalmers: Channel swimming—the great leveller

17 Dec, 14 | by BMJ

Channel trafficAs soon as I opened The BMJ Christmas paper, Captain Webb’s legacy: the perils of swimming the English Channel, I knew I was in for something different. The Channel fare I’m used to consuming often begins with lazy questions, such as: “If you need a pee in the water, can you get on the boat”’

Answer: “No. You’d be disqualified, and if you’re swimming in billions of gallons of water, why would you want to?”

This paper was, interesting, informed, and authoritative, and the accompanying short film by Martin Freeth also brought memories flooding back of my own solo Channel swim in 2005. more…

Nancy Devlin, John Appleby, David Parkin: Why has the PROMs programme stalled?

3 Dec, 14 | by BMJ Group

In 2009, the English NHS introduced a world leading initiative in the pursuit of quality healthcare: the measurement of patients’ views about their own health became a routine part of the delivery of NHS funded services. In an initiative led by the Department of Health, robust and reliable condition specific and generic (EQ-5D) patient reported outcome measures (PROMs) are now completed by patients both before and after four elective surgical procedures. more…

Yogesh Jain and Raman Kataria: The pathology of a public health tragedy

3 Dec, 14 | by BMJ Group

yj_pic Lessons from the Bilaspur sterilization camp 

The recent deaths of 13 women in India operated on at a sterilization camp in Bilaspur, Chhattisgarh, has thrown up urgent questions on the delivery of these services. As doctors observing health systems for the poor from close quarters in Bilaspur for the last fifteen years, we are convinced this was a tragedy waiting to happen. It is a collective failure of our society as a whole to see the stark inequity that erodes the health system, which these poor women have had to pay for with their lives.

more…

Nigel Hawkes: Searching for truth behind the taboos—or how science demystified sex

20 Nov, 14 | by BMJ Group

nigel_hawkesSerious students of sex, from Krafft-Ebing onwards, have not always had an easy time, possibly because some of them were distinctly odd. A new exhibition at the Wellcome Collection in London, The Institute of Sexology, explores the world of those brave pioneers through documents, photographs, letters, films, and objects that trace the gradual unveiling of sexual behaviour by science. more…

John Illman: Richard Asher exhibition at the RSM

12 Nov, 14 | by BMJ Group

John Illman in front of a chandalierAn exhibition celebrating Richard Asher (1912-69), perhaps the greatest medical wordsmith of his generation, opened last week at the Royal Society of Medicine, London.

Asher was acclaimed as a superb diagnostician, as well as for his clarity and wit in both the spoken and written word. His 1947 paper in The BMJ, The Dangers of Going to Bed, which challenged the value of excessive bed rest, was hailed as one of the most influential papers of all time. Asher wrote that while rest was essential in the management of many illnesses, he wanted to “disclose the evils of overdose.” more…

David Wrigley: Like another bad penny?

31 Oct, 14 | by BMJ

david_wrigleyWe have just seen another report from a London based “think tank,” suggesting profound changes to the way the NHS works. These reports seem to turn up with annoying regularity and are often not written with any evidence base to support them, but they do seem to promote the views of organisations that donate vast sums of money to them. A few months ago we had Reform suggesting that we should introduce a regular payment for all patients to use the NHSan organisation that receives around a million pounds of funding from the very same insurance firms and private companies who would benefit from a “cash for treatment” healthcare system…

The latest idea can be found in a report from the Centre for Policy Studies (CPS)—a think tank founded by Margaret Thatcher in 1974, now chaired by Lord Saatchi, with CPS council members including David Willets MP, Brooks Newmark MP, John Redwood MP, Oliver Letwin MP, and Tim Montgomerie.

more…

William C Cayley: Social history on the back roads

31 Oct, 14 | by BMJ

bill_cayley_2Social context and relationships may shape what drives our patients, but sometimes the best way to ponder these is on a drive!

En route to a home visit today, I was met at the edge of town by a road crew doing last-minute sealing work before the onset of winter (despite what you may have heard, Wisconsin only has two seasons—winter and road construction!). As I sat mildly frustrated at the wait until they let us pass, I found myself wondering how many of the road crew, might actually be my patients. (In the end, no faces were familiar, but still it left me thinking).

The home visit was actually relatively straightforward, nothing new going on, no new needs requiring attention. On departing, I decided to both avoid another road construction delay, and take some back roads into town that I seldom explore.

more…

Mary E Black: Inside the mind of a Member of Parliament

31 Oct, 14 | by BMJ

maryeblack copy

I had the opportunity to listen to a number of MPs explain how they think during the excellent Westminster experience  organized by Cumberlege Eden & Partners as part of my NHS Executive Fast Track Programme. I took notes from the MPs—current and recent—whom we met. The session was targeted at senior people in the NHS, but it could be generally applicable to other organizations.

Here are 10 examples of what might be running through their minds as you approach them for a long-awaited meeting.

more…

Cordelia Galgut: Emotional support through breast cancer

30 Oct, 14 | by BMJ

cordelia_galgut

Before being diagnosed with primary breast cancer myself, aged 49 in 2004, I would offer emotional support to women with this diagnosis, and arrogantly assume I understood pretty well what they were going through, at all stages—and my then clients were too polite to tell me to the contrary. Little did I know! Life on the other side of the breast cancer divide, as a patient, not a psychologist, differed hugely from how I understood it to be. For a start, it was a much more harrowing, long drawn out process, both physically and psychologically, than I could ever have imagined. It challenged my sense of myself as a woman much more than I could ever have foreseen, to say nothing of my theoretical beliefs as a psychologist. Indeed, I still suffer breast cancer’s fallout 10 years on. more…

Suzie Bailey: Strategy development – starring role or chorus line?

30 Oct, 14 | by BMJ

Suzie-BaileyIs “transformation” one of the most overused words in relation to the NHS and the issues it faces? Just last week, I heard a NHS deputy CEO joke that the word should be banned, and thought I’d happily join him! On the other-hand, “strategic development” is rarely mentioned. This is strange, as isn’t the NHS going to need to do more of both to overcome its quality, demand, and financial challenges?

The Five Year Forward View echoes this sentiment, that strategy is a vital part of the NHS. So, if strategic development has a starring role in helping the NHS’s clinically and financial sustainability—whose job is it?

more…

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