Sir William Osler advocated the concept of a “quinquennial brain dusting“: which was my justification for taking a week out to visit some integrated care organisations on the West Coast of the USA, with a group from the NHS.

I know we feel challenged in the UK, but the scale and nature of the challenge in the USA made me wonder whether we shouldn’t really count ourselves lucky. The system there is definitely not one to be emulated. International comparators reveal high costs, inequity and, overall, poor outcomes for the population in general. Public spending in the USA covers 30% of the population and represents 8% of GDP. The UK spends 7.8% of GDP on the NHS, for 100% of the population. more…

We’ve been working on how to help specialists make better use of our content. So this week we’re launching the first of what will be a series of specialty portals available on bmj.com. These three new portals focus on diabetes, oncology, and clinical trials, pulling together everything we’ve published on those topics in the BMJ, our specialist BMJ Journals, BMJ Learning, and our clinical community doc2doc. They also provide links to relevant specialty jobs from BMJ Careers. more…

A few weeks ago, I drew your attention to blogger Richard Lehman’s weekly review of general medical journals, a personal appraisal and one-stop shop of what’s interesting for primary care doctors.

As well as Richard’s selection, we also have our own “Shortcuts,” a weekly section that provides concise summaries of articles from general medical journals. more…

After months of preparation, bmj.com has just moved to a new technical platform. The website looks different and has many new and improved features. However, a few features and functions are not yet working as intended, so please do not be disappointed if things look unfamiliar or seem frustrating. We are working hard to rectify any problems, and we hope you will like the new bmj.com. Below is a selection of what you can find there this week. more…

Further on in this blog, columnist Douglas Kamerow focuses on the seeming competition for funding among US health prevention programs (“Smoking versus obesity: must we target only one?”). But individuals can make a contribution too, rather than relying exclusively on politicians and government reforms to support public health measures. Elizabeth Loder, the BMJ’s US based clinical epidemiology editor, blogs about a charity dinner hosted by an organic farm business in an affluent suburb of Boston, which brings its super-crop of luxury tomatoes to less fortunate parts of the population, at drastically reduced prices: “Brookwood Farms, it turns out, is on a mission, in partnership with the Mattapan Food and Fitness Coalition. The aim is to make fresh, organic local produce available and affordable to the residents of Mattapan, an area of Boston that meets many criteria for being a ‘food desert.’ … I’m sure this particular dinner achieved its purpose. I know I will be making a contribution to Brookwood. Who can eat such magnificent food and not be moved to help make its ingredients available to all? The event got me thinking that while homegrown tomatoes are a great thing, so is homegrown charity. Americans are used to giving generously to charitable efforts around the globe, but pockets of great need and deprivation exist right here. Contributing to a local effort such as Brookwood may not seem as glamorous as contributing to global causes espoused by celebrities, but it surely merits more attention than it currently receives. Perhaps, like the best tomatoes, the best sort of charity is also homegrown.” Food for thought? more…

The BMJ has a new policy of asking authors of eligible research articles to pay a publication fee.  It only applies when the funder has already pledged to pay for open access publication and when authors can claim from their funder, the BMJ fee, in full, for that specific piece of research.

The move does not affect the journal’s publication policy. All submitted research will continue to be judged entirely on its importance, originality, quality, and relevance, and all research will remain openly accessible, regardless of whether a fee has been paid for its publication. more…

The focus at our daily planning meetings this week has not been the UK, nor indeed the US, but the natural disasters engulfing the world. Smog in Russia, flooding and fears of a cholera outbreak in Pakistan, the murder of aid agency workers in Afghanistan, including British doctor Karen Woo.

Visit bmj.com for the regular updates on these stricken areas. On BMJ blogs, Vasiliy Vlassov, Professor of Medical Sciences at the Moscow Medical Academy, describes how the smog is affecting local health services. And on doc2doc, BMJ Group’s clinical community for doctors worldwide, Saqib Noor, blogs from Pakistan about the situation there. Some of you may have read his earlier blogs from Haiti. Read his posts at http://bit.ly/buyfHz more…