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US healthcare

Alvin Chan: Chances are, you’re not sensitive to gluten

5 Mar, 15 | by BMJ

alvin_chanIn the medical community, there are certain conditions that fall under the fuzzy category of medically unexplained syndromes (MUS). These syndromes, like fibromyalgia, chronic fatigue syndrome, and somatoform disorder, present with odd constellations of symptoms that neither physical examination nor diagnostic tests can explain. [1] To some members of the medical community, these are not diseases in their own right, but rather, clinical manifestations of underlying depression or some other biological or psychological condition. Given all the attention gluten is getting these days, I’m beginning to wonder if gluten sensitivity belongs in this category of MUS or is simply a result of the gluten-free fad. more…

Tessa Richards: Big data—jam tomorrow

5 Mar, 15 | by BMJ

Tessa_richardsRest easy in your beds overworked doctors and ailing patients, for tomorrow, all will be well. Big data will revolutionise healthcare. Processes in creaky health systems will be streamlined, patients empowered, and outcomes improved. Upbeat messages permeated the air at the UK e-health meeting at Olympia in London this week ( E-health is more a joined up state of mind than a technology, a tweeter observed, and a smorgasbord was on offer. It included workshops on service transformation and informatics priorities, best practice cafes, “future zones,” “digital plenaries,” and numerous tech company stands. The programme listed 501 in total. Some with enticing names, such as Clarity Informatics and Co–ordinate My Care. But frustration was in the air too…. more…

Saurabh Jha: War on Death

3 Mar, 15 | by BMJ

Saurabh_JhaThomas Hobbes described life as pitifully “nasty, brutish, and short.” Thanks to the free market and the state, life is no longer a Hobbesian nightmare. But death has become nasty, brutish, and long.

Surgeon and writer, Atul Gawande, explores the medicalization of ageing and death in Being Mortal. Gawande points to a glaring deficiency in medical education. Taught to save lives and fight death, doctors don’t bow out gracefully and say enough is enough. We’re not taught about dying. We’re taught about not dying. more…

William Cayley: What are the (hidden) costs?

26 Feb, 15 | by BMJ

bill_cayley_2“The economics of education are changed dramatically by delivering online courses to large numbers, making expensive education much cheaper.” That line in Richard Smith’s blog post describing a proposed “global university” for healthcare workers caught my attention—especially since my own local statewide university system, of which I am an employee as a medical school faculty member, is facing a proposed $300 million budget cut over the next two years. more…

The BMJ Today: Childhood drowning outcomes—prevention is key

12 Feb, 15 | by BMJ

My Facebook feed was filled with complaints after the National Football League’s Superbowl broadcast last week. The target? A commercial from an insurer highlighting the importance of preventing childhood accidents. While commenters seemed to acknowledge the importance of the topic, they felt that the message was too dark for an event that is otherwise generally upbeat and fun (at least for fans of the winning team). Given the social media response the commercial did at least succeed in catching viewers’ attention. more…

Marika Davies: Doctors and death row—should doctors ever take part in executions?

11 Feb, 15 | by BMJ

marika_daviesThe US Supreme court has put three executions in Oklahoma on hold while it considers a legal challenge to the state’s use of midazolam in its lethal injection protocol. This is likely to reignite the debate about the involvement of doctors in capital punishment, a practice that is prohibited by the American Medical Association, but permitted and often even required by state law. more…

Rahul K Parikh: Violence against doctors in the US

9 Feb, 15 | by BMJ

Late last month, Stephen Pasceri walked into a Boston hospital and asked someone to point him in the direction of his deceased mother’s surgeon, Dr Michael Davidson. When he found Dr Davidson, Pasceri drew his gun and shot him. Davidson, age 44, a husband and father of three kids, would later die from his wounds.

Police have said very little about what happened. Pasceri committed suicide just after he committed murder, and thus, in the ensuing days, there has only been speculation about his motives and mental state.

This much we know. Pasceri, like so many Americans, was a do it yourselfer. That meme is usually reserved for folks who, proudly and diligently, build their own kitchen, restore a dilapidated automobile, or otherwise—with their hands, head, and heart—get the job done themselves. It’s a point of pride, a cultural moniker that, though not solely American, is attributed to us and celebrated by us every day. more…

Vincent Iacopino: Health professionals have no role in Saudi blogger’s flogging case

2 Feb, 15 | by BMJ

CGIThe disturbing case of a Saudi blogger sentenced to flogging should serve as a reminder that health professionals should never participate in torture or cruel, inhuman, or degrading treatment.

Raif Badawi, 31, was sentenced last year to 1000 lashes and 10 years in prison for insulting Islam after he criticized Saudi clerics on his blog. Following his first round of flogging on 9 January, his second round of punishment was postponed for the third time on Friday. Earlier delays reportedly occurred because doctors found he was not physically fit for further lashing. While it may appear that the doctors are assisting Badawi by delaying punishment, their participation is actually enabling the infliction of physical and mental pain. more…

Stuart Buck: Sharing data from past clinical trials

30 Jan, 15 | by BMJ

Stuart_BuckThere was a time when academic and government researchers performed experiments that were clearly unethical—such as letting syphilis go untreated, or asking people to administer severe electric shocks to each other. Ethics review boards sprang up in an important effort to make sure that research on human subjects remained within the bounds of legality and ethics. But for all the good that ethics review boards do, today they often block undeniably valuable research from going forward. The re-analysis of clinical trial data is a recent case where specious ethics objections are used to stymie good research into the effectiveness of drugs given to patients. more…

Desmond O’Neill: Older drivers and medical fitness to drive

19 Jan, 15 | by BMJ

desmond_oneillDoes life really imitate art, or is it the other way round? Listening to an exhilarating live performance by the Philadelphia Orchestra of Till Eulenspiegel’s Merry Pranks, the droll tone poem about a famous trickster by Richard Strauss, I was struck by the notion that this might be the first description of ADHD through music. more…

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