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Ian R Barker: Compassion fatigue—the neglected problem

20 Sep, 16 | by BMJ

ian_barkerCompassion fatigue—also known as vicarious traumatisation results in a gradual reduction in compassion over time. It is more common in those dealing with trauma or caring for close relatives (1). If often presents as hopelessness, decrease in experience of pleasure, constant stress and anxiety, and a pervasive negative attitude (2). Interestingly, it has been claimed that as a result of the media portraying constant tragedy the general public has been somewhat more cynical and resistant to suffering, a form of compassion fatigue. more…

Nick Hopkinson: Saving the NHS—a lesson from Carthage

20 Sep, 16 | by BMJ

nick_hopkinsonCato the Elder is said to have concluded every speech he made in the Roman Senate, regardless of the topic, with “Delenda est Carthago”—Carthage must be destroyed. In answering the Editor of The BMJ’s call for ideas on how the medical profession can protest against the destruction of the NHS, a similar clarity and consistency of message is essential.

The simple proposal is that in every discussion on every topic of medical interest, the management of long term conditions, novel therapies, the causes and the cures of cancer, avoidable deaths, whatever thing awareness is being raised about this week, good news or bad, doctors need to include a clear statement that it is government policy to underfund the NHS by £20 billion pounds by 2020. more…

Health apps and how to evaluate them: Review of the PHE 2016 conference, part two

20 Sep, 16 | by BMJ

suchita_shahEmbedded in the NHS Five Year Forward View is a sleek, bullet pointed ministerial promise: “an expanding set of NHS accredited health apps that patients will be able to use to organise and manage their own health and care.” Whatever your views might be on ministerial promises, it’s definitely true that digital technology is making its way into mainstream public health. In my previous blog, a roundup of several sessions at the Public Health England (PHE) annual conference, I wrote about how digital technology is partnering with behavioural science to influence the health choices we make. Here, I’ll share what I learned about health apps. more…

Using behavioural science and digital technology to “nudge”: Review of the PHE 2016 conference, part one

19 Sep, 16 | by BMJ

suchita_shahBeing a GP at a public health conference is, I imagine, like being a proctologist at a plumbers’ convention: familiar subject matter, different perspective. I spend a lot of my clinical time advising people about smoking, alcohol, healthy eating, weight loss, mental health, contraception—all sorts of things that have at their core the vagaries of human behaviour—but I’m not sure I do it very well. A tidal wave of long term conditions is flooding the NHS, and I’m always interested to know what new tricks the population health approach has to address these. more…

David Zigmond: How and why do we retire? Ill omens for younger doctors

14 Sep, 16 | by BMJ

david_zigmond2The nature of our departures from our work often tells us much about what kind of problems are being left behind. The individual may escape, but what about the wider community?

The continuing troubles and discontents of junior doctors have evident newsworthiness; not so the equivalent problems in later careers. This is easy to understand: younger doctors have (we hope) a long future career ahead—that future is also our future healthcare, so we want them to be there, and in fine fettle. Older doctors will have retired from that picture: we are less concerned. more…

Maslah Amin: How can the NHS tackle the white male dominance of leadership roles?

5 Sep, 16 | by BMJ

maslah_aminThe lack of women and people from a black, Asian, or other ethnic minority (BME) background in senior NHS positions is well known. It is in and out of the news and you hear it discussed on the shop floor among colleagues. Yet it continues to persist. Researcher, Roger Kline’s 2014 survey of discrimination in the NHS outlined it very well. The higher you go up the NHS seniority ladder, the whiter it gets, hence the title for his work “Snowy white peaks.” Also the higher up you go, the fewer women there are in those positions. Many other documents have discussed this issue. In the past two years there has been a push to improve the lack of diversity among senior NHS staff. However the latest evidence suggests that results remain poor. more…

Rammya Mathew on the national childhood obesity strategy—doctors need to champion public health

25 Aug, 16 | by BMJ

rammya_mathewI was left mortified after reading about the long awaited national childhood obesity strategy. “Underwhelming” would be the single best adjective to describe it. On reading the newspaper headlines, however, it is all too tempting to pass the buck to Public Health England and Dame Sally Davies et al. However, there is a sense of unease about this. I can’t fight the feeling of responsibility to demand more of our government. It seems incongruous to dedicate our working lives to treating disease and yet turn a blind eye to public health policy that is set to fail a generation. more…

Sara Martin on emotional labour

22 Aug, 16 | by BMJ

sara_martinI work at a great place in the UK. We have gorgeous facilities, friendly staff, great benefits, and—most important to this American doctor—unlimited free coffee (and tea if you’re British).

But this summer, I will be heading back to clinical medicine. In preparation, I have been thinking a lot about what I have mentally termed the “emotionals:” emotional labour, intelligence, and resilience. more…

Peter Thomson: Would revoking the European Working Time Directive improve surgical training?

17 Aug, 16 | by BMJ

shift_workThe President of the Royal College of Surgeons of England suggested recently that leaving the EU will allow surgeons to undergo thousands of hours of extra training. Following the Brexit result, we are faced with the potential revoking of the European Working Time Directive (EWTD). The anti-EWTD-ers may now see their dreams come true, and this argument evokes significant similarities between the anti-EWTD debate and the mendacious EU referendum campaign. more…

Tony Woolfson: How can we fill vacant consultant posts?

17 Aug, 16 | by BMJ

tony_woolfsonA Public Accounts Committee report suggested that the large number of unfilled consultant posts was due to bad workforce planning. Hardly surprising really. Obviously true, but not really the point. If we are to engage with and solve the problem, we need to look at what lies beneath.

Having been involved with doctors’ careers since the mid-1980s, I have become increasingly concerned that changes in funding and management would make NHS medicine a less and less desirable option. Sadly, many of my fears seem to have been justified and now we have low morale, vacant posts, and doctors leaving in alarming numbers. more…

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