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Tiago Villanueva

Tiago Villanueva: Primary care in Brazil’s largest favela

29 Nov, 16 | by BMJ

tiago_villanuevaWalking through Rio de Janeiro’s largest slum, Favela da Rocinha, in the pouring rain is probably not the wisest thing for a foreign visitor to do. But on a recent trip to Rio, I was determined not to squander the one chance I had to visit the Maria do Socorro Silva e Souza Family Health Clinic—one of Rocinha’s three primary care clinics that belong to Brazil’s public “Unified Health System.” I went with a group of about 15 GPs from all over the world. The clinic provides care to about 33 000 inhabitants of Rocinha, which has an estimated population of around 100 000, and covers a very well defined area of the favela.

I had heard about the impressive developments in primary care in Rio de Janeiro over the past few years, where primary care coverage has gone from about 4% to about 70% within a decade. more…

Tiago Villanueva: What is it like working as an “Uber-style” doctor?

15 Nov, 16 | by BMJ

tiago_villanuevaThe steady “Uberification” of modern life continues, and with it have come companies that provide “Uber style” medical home visits for patients.

KNOK began operating in Portugal in December 2015. A patient can call a GP and a number of other specialists through an app. This lets you see a map which shows which doctors are online at any time of the day and what their current geographical position is. It is also possible to call a doctor through their website. If a doctor receives and accepts a consultation request, he or she is guided by the app to the patient’s home via GPS. The patient can see the doctor’s progress on the app and the estimated time until arrival.
more…

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…

Tiago Villanueva: Co-payments in general practice—the Portuguese experience

11 Jan, 16 | by BMJ

tiago_villanuevaSince 2011, I’ve worked as a locum GP in Portugal’s national health service, where patients pay five euros for each appointment with a GP. Many people are exempt from paying, for exemple pregnant women, children up to 12 years of age, unemployed people receiving benefits, and patients who have had transplants.

The co-payment to see a GP was 2.25 euros until 2011, but this figure increased the following year to five euros as part of austerity measures implemented by the then Conservative governmentmore…

The BMJ Today: China, philanthropy, statistics, Minerva, and what your patient is thinking

15 Oct, 15 | by BMJ

• In his acclaimed weekly blog, Richard Lehman highlights a cluster of articles on healthcare in China. Acute kidney injury seems to be an emerging problem in China as many traditional herbal products may contain nephrotoxic plant substances, with more than 70% of patients giving a history of possible toxic drug ingestion.

peter_sandercock• Peter Sandercock, featured in the latest BMJ Confidential, says that if he was given £1 million he would invest half in training doctors from low and middle income countries on stroke prevention and treatment, and give the other half to advocacy groups lobbying governments towards better control of the global tobacco and food industries. more…

The BMJ Today: Doing the right thing, doing the wrong thing, and the Hawthorne effect

10 Sep, 15 | by BMJ

gp_surgery_waiting• Samir Dawlatly explains in a blog the barriers that he faces daily as a practicing GP, which often hinder him from providing high quality healthcare. He gives the example of a patient presenting with tiredness and says that, under pressure, it is much more difficult and time consuming to explain why blood tests aimed at investigating certain causes of tiredness are often not needed, rather than simply requesting tests. more…

The BMJ Today: Patient centred outcomes research

3 Aug, 15 | by BMJ

warfarin_tablets• A research paper looks at the association between warfarin treatment and longitudinal outcomes after ischaemic stroke in patients with atrial fibrillation in community practice, using a large registry of patients admitted to US hospitals with acute ischaemic stroke. The study found that new prescription of warfarin in patients with atrial fibrillation after stroke was associated with a lower risk of major adverse cardiovascular events, all cause mortality, and readmission for ischaemic stroke, as well as more institution free home time—the latter being a patient centred outcomes measure, which means being alive, without recurrent stroke, and without being hospitalised for complications. more…

The BMJ Today: The NHS in the aftermath of the UK’s general election

11 May, 15 | by BMJ

louise_irvine2

GP Louise Irvine of the National Health Action Party.

• Gareth Iacobucci reports that the National Health Action Party secured just over 20 000 votes across 12 constituencies in the UK general election. In three constituencies, it achieved fourth place finishes. The National Health Action Party was formed by doctors and health campaigners in 2012 in protest against government policies for the NHS.

BMJ editors Sally Carter and Emma Parish blog about the play “Who Cares?” by Michael Wynne, a verbatim play that discloses interviews with NHS staff. Even though the play succeeded in giving a voice to those who are less likely to be heard, it didn’t offer many solutions to improve the NHS. more…

The BMJ Today: Thinking about common and not so common conditions

8 Apr, 15 | by BMJ

pityriasis• Pityriasis versicolor is a superficial fungal infection of the skin that is commonly seen in general practice. The latest practice pointer looks at its diagnosis, differential diagnosis, management, and prevention.

One particular aspect about its management is that first line treatment comprises shampoo containing either ketoconazole, selenium sulphide, or zinc pyrithione.

• Iron deficiency anaemia is another common condition seen in primary care. A news article reports that the influential United States Preventive Services Task Force considers there is not enough evidence to gauge the balance of benefits and harms of screening for iron deficiency anaemia in pregnant women and children aged between 6 months and 24 months. more…

Tiago Villanueva: Returning to medical school 10 years later

26 Mar, 15 | by BMJ

tiago_villanuevaA few weeks ago, I returned to the Faculty of Medicine at the University of Lisbon—the medical school from where I graduated ten years ago. The reason was to participate at the AIMS meeting, an international conference for medical students as both a member of the jury of the oral presentations and as a speaker.  more…

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