You don't need to be signed in to read BMJ Blogs, but you can register here to receive updates about other BMJ products and services via our site.

William Cayley: Out with the old (and practical) and in with the new (and techie)?

29 Jan, 16 | by BMJ

bill_cayley_2Out with the old and in with the new? Improvements in the quality and portability of electronic diagnostic equipment have led to increasing discussion of late over the possible demise of the stethoscope. News outlets for the general public and for medical professionals have noted the growing debate over whether portable and handheld ultrasound, as well as other electronic diagnostic devices, should replace the traditional tool and icon of the physician: the stethoscope.

I tend to be a bit of a skeptic about the alleged wonders of the latest and greatest technology, and admittedly have a bent towards sticking with what is proven to work. So, to further investigate the potential merits of the stethoscope and its competitors, I had a brief (and admittedly limited) look for quality studies addressing the question. more…

Jeffrey Aronson: When I use a word . . . Apothecaries

29 Jan, 16 | by BMJ

jeffrey_aronsonLast Saturday (23 January) I went to Sam Wanamaker’s Globe Theatre in Southwark (picture) for a meeting of the Oxford–Globe Forum for Medicine and Drama in Practice, as part of the commemorations of the 400th anniversary of Shakespeare’s death in 1616, expertly organised by Shakespearean scholar Professor Laurie Maguire and her colleagues.

I gave a talk about the historical development of medicines regulation, relying heavily on R G Penn’s paper in the British Journal of Clinical Pharmacology, “The state control of medicines: the first 3000 years”. Having only 15 minutes to cover the subject, I restricted myself to the past 2000 years. I finished with what were not perhaps wise saws but certainly modern instances, describing some recent work on drug withdrawals more…

David Kerr: A bump on the road to mHealth utopia?

28 Jan, 16 | by BMJ

david_kerr_2015picA recent clinical trial’s finding that digital health technology (also known as mHealth) failed to reduce healthcare costs is raising eyebrows on this side of the Atlantic. For naysayers the results will most certainly reinforce their belief that mHealth is a fad, which distracts from the real business of medicine, and that more investment in staff is preferable to wasting time on smart new shiny things. On the other side of the argument, however, the study had major flaws: it had a small number of participants (3998), had a very short duration, and was already out of date when it started—given the rapid pace of technology development.

Where I live on the west coast of the US, only a few hours’ drive down from Silicon Valley, there is indeed a widespread belief that technology will change the future and much sooner than for previous generations. more…

Jeanelle de Gruchy: Should David Bowie have spoken out about the cause of his cancer?

28 Jan, 16 | by BMJ

jeanelledegruchy2David Bowie has died. From cancer. So much outpouring of grief. And yes I participated, posting #RIPBowie tweets and reminiscing about seeing him in concert in Montreal as an 18 year old with all who would listen, shedding a tear listening to the day long radio tributes as I felt my youth slipping away with his passing. And yet everything I watched, on TV, on YouTube, on Facebook and in the many pictures, there it was, revelling in its strong silent presence and mocking us for our complicity, the killer that took him away from us aged only 69. The swell of adulation for one of the greatest musicians, pop stars, cultural icons, and boundary pushers was wonderful; the lack of comment on what killed him prematurely was pitifully duplicitous. more…

Enes Hajdarbegovic and Deepak Balak: Science, spam, and scam

27 Jan, 16 | by BMJ

Enes-Hajdarbegovic_2Deepak-Balak_2Hi there! Are you interested in making easy money? Go into scientific publishing with this easy three step programme:

The first step is to get yourself a website. Get some server space from any of the super cheap providers and get your HTML magic going. Create a biomedical journal with a name that sounds a lot like an existing top journal. Make sure to include words such as experimental or clinical or reviews. Finally, furnish the website so that it resembles that journal.

The second step is to find willing customers. Don’t worry, plenty of those! more…

Paul Sooby: The last of an endangered species? The view of a LAT trainee

27 Jan, 16 | by BMJ

paul_soobyIn January 2016 NHS employers withdrew locum appointed for training (LAT) posts in England. The numbers of doctors undertaking LATs has fallen since 2014 and there were vacant posts last year. There are concerns that doctors staying in LATs year after year gain pay progression without career progression, and that direct observation and educational supervision can be harder to review.

So, the solution to these potential problems was simple—scrap the whole programme.

My confession, I did not get my specialty training number (NTN) at first attempt. This was not because I didn’t prepare enough for the interview, or didn’t have enough clinical exposure, or wasn’t engaged in enough academic activity to enhance my CV. It was because on the day, on what should be considered an exam rather than a job interview, I didn’t score as highly as my peers in one station. I ranked six places below the cut-off for a NTN. I can’t begin to tell you how demoralising that was, and how hard it was to realise that all the work, preparation, and courses had been in vain. more…

Elizabeth Wortley: Please refrain from using that kind of language

26 Jan, 16 | by BMJ

We talk a lot about communication in medicine and try to teach the right skills to students, such as the importance of body language and simplifying medical terminology. But how often do we look at non-medical language and the effect it has?

Suzanne Gordon’s BMJ blog “Medicine’s F word—Fail” in early December reminded me to do better with our population of somataform/psychological/recurrent disorders (what is the correct term?) whilst also battling my fear of them. In paediatrics we don’t often talk of our patients “failing,” but we do have our own language problems. As a registrar, I’ve had multiple approaches to the recurrent patient “problem” explained and demonstrated, and perfectly nice people (myself included) find themselves ranting behind closed doors, only to then attempt their best “comms skills scenario” face in the clinic room. I can’t say I believe this is a successful tactic, and the only times I’ve seen it done well are by the small and select group who understand the impact their baseline attitudes have towards these encounters. more…

John Fabre: The absence of a national leadership structure within the NHS

26 Jan, 16 | by BMJ

2015_0922_1725_Neil&EllaBarclay&John&ClarissaFabre_JW_DSC_8336The strike by junior doctors illustrates a fundamental fact about the National Health Service: the de facto chief executive is the minister for health, and there are no advisory or decision making bodies between him and doctors and nurses at the coal face. While there was a broad consensus for the principles underlying the NHS, this was not a serious problem. Over the past 20 or 30 years it has been the root cause of the initially slow and now accelerating demise of the NHS. more…

Amir Hannan: Please don’t forget the patient

25 Jan, 16 | by BMJ

amir_hannan“Please don’t forget the patient.” So said Clare Reynolds—one of the many delegates who came along to the Long Term Conditions (LTC) conference. The welcome letter claimed it will “seek to identify the greatest challenges facing those living with LTCs.”

The conference started off well with the keynote speech from Jacquie White, deputy director for Long Term Conditions NHS England, quoting William Osler from the 1800s: “The good physician treats the disease; the great physician treats the patient who has the disease.” We were reminded that there are 16 million people in this country with an LTC, 10 million people with two or more LTCs, 70% of the health budget is spent on LTCs, 33% of GP consultations are with people with LTCs and on average patients spend only 0.01% of their time with a healthcare professional. We learned from Graham Prestwich, Lay Member for NHS Leeds North CCG about Alistair Brewis, a respiratory consultant who, 30 years ago, took time to write and sketch out on paper an individual’s plan in the patient’s presence. This is a more effective way of educating each one about his or her particular condition. more…

Sadie Boniface and Sally Marlow: Mother’s ruin? New guidelines for alcohol consumption during pregnancy

25 Jan, 16 | by BMJ

sally_marlowsadie_bonifaceThe Chief Medical Officer’s proposed new drinking guidelines were announced on the 8th January. These included specific advice about drinking during pregnancy, to which we could not do justice in our previous post about drinking guidelines. The new guideline says “if you are pregnant or planning a pregnancy, the safest approach is not to drink alcohol at all, to keep the risks to your baby to a minimum.” This is out for public consultation, with the rest of the proposed guidelines (closing date 1st April). more…

BMJ blogs homepage

The BMJ

Helping doctors make better decisions. Visit site



Creative Comms logo

Latest from The BMJ

Latest from The BMJ

Latest from BMJ podcasts

Latest from BMJ podcasts

Blogs linking here

Blogs linking here