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Guest bloggers

James Partridge: A new dimension for treating acne

5 May, 16 | by BMJ

James PartridgeI was recently invited to speak on “new models of care” at a meeting of the All Party Parliamentary Group on Skin at the House of Commons. I chose to speak about a new approach to address the failure of the NHS to tackle the angst and distress felt by so many people with skin conditions like acne.

What is well recognised is that acne, like other common skin conditions, affects large numbers of people, those in adolescence and young adulthood primarily. more…

Kawaldip Sehmi: The patient-centred approach of the Hillsborough inquest

29 Apr, 16 | by BMJ

Kawaldip SehmiRespecting the families’ euphoria and personal grief, I delayed this blog post on the Hillsborough inquest verdicts (the verdict came at lunchtime 26 April 2016). Let them savour their day in court, and well done to all on the Justice For The 96 campaign, especially Michael Mansfield QC, who has now got into a bit of a habit of shaking the conscience of our society and our complacency about our state agencies.  more…

Jane Parry: Organ donation is an emotive topic, and rightly so

28 Apr, 16 | by BMJ

jane_parry3Recently, there was a very moving piece in The Guardian about a doctor’s experience of a family donating their dead child’s organs for transplant. It got me thinking about organ transplantation here in Asia, specifically in Singapore, and why donation rates there are so low.

Singapore has an opt-out organ donation policy: a 2009 amendment to the Human Organ Transplant Act (HOTA) allows for “the kidneys, liver, heart, and corneas to be recovered in the event of death from any cause for the purpose of transplantation, applicable to all Singapore Citizens and Permanent Residents 21 years old and above, who don’t have mental disorders, and who have not opted out.” Opting out of HOTA means that you are lower priority on the waiting list for an organ transplant. more…

Steve Ruffenach: Footprints old and new

21 Apr, 16 | by BMJ

steve_ruffenachA recent discovery of ancient footprints on the beach in Happisburgh, UK has set the archeological world aflutter. Scientists working at the scene have discovered pre-historic footprints left by our ancestors some 850,000 years ago. As reported by PLOS One, the details of the findings have challenged some long-standing beliefs regarding ancient human behavior and migration.

It is interesting to note that the archeologists who found the footprints did so without much, if any, help from their always-on, omnipresent assistant Tech. No scanner of sorts to guide the scientist, no eye in the sky interpretation of land mass patterns. Rather, all they had was a practiced eye and a keen sense of suspicion that valuable discoveries might be afoot. more…

Natalie Blencowe and Jane Blazeby: Beyond Buxton—establishing when the time’s right for a surgical trial

20 Apr, 16 | by BMJ

Natalie_blencowe_2016jane_Blazeby_2016In 1987 Martin Buxton observed that “it’s always too early [to evaluate] until suddenly, unfortunately, it’s too late.” This is particularly true in surgery. In most countries, there is rapid diffusion of new surgical techniques. This usually occurs without evaluation, perhaps reflecting a combination of surgeons’ enthusiasm for innovating and a misunderstanding of evidence based practice.

A lack of evaluation may mean that, at best, innovative (and superior) procedures spread haphazardly. At worst, however, it could mean that innovative (and inferior) procedures are introduced widely before their deficits are noticed, potentially leading to harm. more…

Paul Hodgkin: The dogs that don’t bark are the most difficult to hear

18 Apr, 16 | by BMJ

For at least the last 70 years patients have been regularly gathered in crowded outpatient clinics and left to sit in silence. Decade after decade, country after country, health systems around the world have ignored the massive potential for patients to learn from each other. Forget the rhetoric about listening and engaging patients. Just look at all those crowded outpatient waiting rooms—still silent, still full of the lonely crowds that medicine invariably seems to create whenever it brings patients together. A case of dogs not barking if ever there was. more…

Tara Lamont: How was it for you? Reflections on patient experience research

14 Apr, 16 | by BMJ

Tara_Lamont_3“Expect to see blood in your semen.” This was the shouted afterthought from the clinician to a middle aged patient with prostate cancer across a crowded waiting room as he left the consultation. A room of strangers turned to look at him now thinking, as he pointed out wryly, about his sexual activity. Just a small thing. But one which affected this patient deeply. This was just one of the filmed patient experience stories which can be used as triggers for real change in staff behaviour and service delivery. more…

Kamal R Mahtani: Evidence based mentoring for “aspiring academics”

13 Apr, 16 | by BMJ

Kamal R MahtaniThere are times in our careers when we are not sure what to do next, whoever we are. We may lack experience or the confidence to decide what to do; or we may have made a decision and need a word of advice from someone more experienced, reassuring us that the idea was sensible. At such times, having a mentor to advise, guide, or simply assuage our uncertainties, can be the key to taking the next steps successfully and enhancing our professional development. more…

Martin Roland: Who should have PSA testing for prostate cancer?

12 Apr, 16 | by BMJ

martin_rolandDoctors and patients are confused by PSA testing. In January 2016, the UK National Screening Committee recommendation concluded that “Evidence shows a benefit of prostate screening to reduce prostate cancer deaths by 21%. Despite this significant reduction, the major harms of treating men who incorrectly test positive still outweigh the benefits. A systematic population screening is not recommended.” This is in line with the US Preventive Services Taskforce which also recommends against population PSA screening. In March 2016, Public Health England (PHE) published a Prostate Cancer Risk Management Programme and the charity Prostate Cancer UK simultaneously published a set of consensus statements on who should be tested. Do these sets of guidance agree with each other, and do they help doctors and patients? more…

Stuart Parris and Sonja Marjanovic: How to galvanise the NHS to adopt innovation

12 Apr, 16 | by BMJ Group

The NHS has a strong history of pioneering health innovations, but has traditionally been better at developing them than adopting them. To address these challenges, Sir Hugh Taylor, former permanent secretary at the UK Department of Health, is leading the “Accelerated Access Review.” The review team recently released its interim report. It puts forward five propositions for improving current pathways for the development, assessment, and adoption of innovative medicines and medical technology in the NHS. more…

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