In July 2012, Anne Marie Slaughter, who is a professor at Princeton, resigned from her high profile position as the director of policy planning for the US State Department in Washington in order to spend more time with her teenage sons. Her resignation was accompanied by her well circulated article, “Why women still can’t have it all” in The Atlantic, that discussed the hardships in achieving work-family balance—and perhaps discouraging younger women from trying to “have it all.”

Several other high profile women joined the discussion and there were additional resignations. The struggle to find time to spend with one’s children seems to be a consistent theme in the reasons women resign from government service. To have it all would be to achieve that great career, and that great relationship with a loving spouse and spunky children—all while having a clean house and manicured lawn. more…

A day in the life of a Chilean family doctor

She wipes her eyes with the backs of her hands. A thin circle of white skin against the dark tan of her left ring finger is the only visible sign of her recent loss. She sits in the ‘sala de espera’. Esperar, in Spanish, means ‘to wait’, but also ‘to hope’. She sits in the room of hope. A room where thirty other souls hope, and (this being a Catholic country) pray, that their lives may become a little better after the meeting with the medico. more…

Overwhelmed by the relentless tide of bad news stories about UK primary care? Well, this is a good news story. A webinar organised by The Commonwealth Fund (a US philanthropic organisation originally created by the Harkness Family to identify policies and practice that could improve the US health system) discussed findings from the latest International Health Policy Survey of Primary Care Physicians conducted in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Switzerland, Sweden, the United Kingdom, and the United States. What did they find? The UK performed very well. While the UK spends 9.6% of its GDP on healthcare, less than its European neighbours, and less compared to 17.6% in the US, the findings were consistently positive in all areas. more…

A week ago, I was writing about rights—in this particular instance, the right to safe water, having personally experienced the city of Santiago without water during my stay in Chile. It seemed to me, as the city waited for water companies, and not hospitals, to oblige, that many solutions to fundamental public health problems lie outside formal health systems. more…

JAMA Intern Med  28 Jan 2013  Vol 173
93    One of the chief glories of this journal (formerly called the Archives) lies in the articles labelled LESS IS MORE, which can range from editorials to original research papers, and this issue contains no fewer than four such. The US health economy contains massive incentives to do too much, while the tendency of the NHS is often to do too little; but it is interesting to see how even in our system, we might be better off if we did less of certain things. Rita Redberg is a very hands-on editor and contributes to three pieces in this issue: here she joins forces to comment on how much overtreatment has decreased in the USA since 1999. The answer, of course, is that it hasn’t at all.
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This blog is the first in a series about you, our readers. Fiona Godlee, the BMJ’s editor in chief, suggested I write a regular blog explaining some of our policies and procedures. Many of them have been in place for decades, but our readership of practising physicians and academic researchers may not be aware of many of them. I’ll aim to choose topics based on recent questions from readers around the world who see the journal in print, online, and on the iPad. more…

Millions of years ago, plants were making fruits to disperse seeds. Once the seeds were ready to travel in animal stomachs, fruits concentrated more sugar and ripened. They became an important and safe source of energy. Consequently, our ancestors perceived fruit to be “sweet” and pleasurable.

Meanwhile bees were busy making a much sweeter food, which also had the highest naturally occurring concentration of sugar. It wasn’t long before hominids, other primates, and Winnie the Pooh risked bee stings and anaphylaxis for honey. Chimpanzees have developed clubs, whisks, levers, drills, and dippers just to extract honey. Humans have revered honey just as much: it was a divine offering in ancient Egypt, the Old Testament asserted that the promised land flows with milk and honey, and Hindus feed honey to newborns in a religious ritual. more…

When visiting a city for the first time, graveyards rarely feature high on my agenda. So, little did I suspect that a very beautiful graveyard would be one of the aesthetic highlights of a recent short stay in Portland, Maine, a compact and attractive port city with interesting French influences. My host, the founder of the most innovative alternative transportation system for older people, ITNAmerica, had also been a prime force in saving and restoring Evergreen cemetery, one of a handful of landscaped garden cemeteries in the world. more…

Mid December saw the launch of the decennial Global Burden of Disease (GBD) study at the Royal Society in London.  The study is the global rating of mortality, morbidity, and disability.

The data tells a familiar story.

Where infection and malnutrition related illnesses were once the primary causes of death, these have now been replaced by death from heart disease, cancer and other chronic disorders. The disease burden is now increasingly defined by disability rather than premature death—with much of this now caused by musculoskeletal disorders, back and neck pain, injuries, and mental health conditions.   more…

Visiting Kennebunkport, Maine, in winter is a surreal experience, almost akin to playing an extra in the Truman Show. Neat clapper board houses and snow encrusted churches cluster around a serpiginous and sylvan sea inlet. In the grocery cum café store locals cluster over coffee and cinnamon buns amid the general supplies in an ambience with a comforting feel of the 1950’s. more…