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Anant Bhan: The Call to Action Summit 2015—thoughts on some key areas for discussion and action

26 Aug, 15 | by BMJ

AnantBhan_BMJblogs_Jul2015

India is hosting the Call to Action Summit on the 27-28 August in New Delhi. The summit is focused on ending preventable child and maternal deaths, and will be co-hosted by the Ministry of Health and Family Welfare, the Government of India, the Ministry of Health Government of Ethiopia, USAID, UNICEF, the Bill & Melinda Gates Foundation, and Tata Trusts. The summit will bring together health ministers from 24 priority countries (contributing 70% of the world’s child and maternal deaths) which signed on to a global call for action for child survival in June 2012 along with researchers, policy makers, funders, experts, and representatives from industry, civil society, and media. The meeting has an interesting and packed agenda. It would be good to see a discussion on the following areas during the summit: more…

Liz Wager: GPP3—thoughts on becoming a guideline grandmother

26 Aug, 15 | by BMJ

lizwager

The third version of the Good Publication Practice guidelines (GPP3) were published last week which makes me a guideline grandmother. Like any grandparent I am excited and proud of my “offspring,” slightly nervous about how the world will treat it, but hopeful that it will grow up to do something useful. And, like a grandmother, I can’t resist telling you some family history. more…

William Cayley: Comfort always and advocacy for the vulnerable

25 Aug, 15 | by BMJ

bill_cayley_2Reading the Monday morning paper, I was greeted by stories about ongoing fights over whether or how to undo the Affordable Care Act (“Obamacare”) and controversies over solitary confinement. Later, while driving to work, I heard more news on the challenges facing those in eastern Europe who are confronted by a rising influx of immigrants. One final check of the news before starting clinic reminded me of the unfolding economic uncertainty that seems currently related to China’s stock market volatility.

Phew—what a way to start the week. And while each of these news stories seems to cast a pall of gloom over the start of the week, at the same time, I think they should serve as a reminder to physicians of what a central piece of our vocation (or calling) needs to be. more…

Samir Dawlatly: Could general practice survive without the NHS?

25 Aug, 15 | by BMJ

General practice is often described as the cornerstone of the NHS. Though its funding doesn’t necessarily reflect this, having its proportion of funding decline in recent years, 90% of all interactions with patients happen in general practice. It is therefore easy to predict that if, for whatever reason, general practice were to collapse or cease to exist as we know it, that the NHS itself would be threatened. The only alternative place for patients to go would be hospitals, via accident and emergency. That is probably an apocalyptic view given that one would hope that if general practice, as we know it, was to cease to exist that this would not happen overnight. more…

Daniel S Goldberg: COI bingo

24 Aug, 15 | by BMJ

goldberg_danielI am fortunate to possess content expertise on ethics and conflicts-of-interest (“COI”) in medicine and science, and I teach it in a variety of health professional settings. After reading the latest news story on a commercial industry’s partnership with academic scientists, I grew tired enough of seeing the same (to my mind) poor rationalizations for the permissibility of such an arrangement to create this handy COI bingo chart. more…

Jim Sherifi: The tyranny of excellence

24 Aug, 15 | by BMJ

Jim Very Good[2]When one reads the history of any autocratic, despotic regime, one is always struck by how they managed to secure the submission of the educated and intelligent through remarkably simple methods. Doctors in the NHS are currently being subjected to the same tried and trusted processes of indoctrination used by totalitarian regimes.

These may be dressed up under laudable banner headlines, such as the General Medical Council’s (GMC) “Working with doctors: Working for patients,” but then Mao also used vague exhortations such as the “Great Leap Forward.” Anodyne words suggesting a greater good, a striving for excellence. Sadly, the consequences are often the reverse and require years to recover from. more…

Jeffrey Aronson: When I use a word . . . Ars magna

21 Aug, 15 | by BMJ

jeffrey_aronsonIn 1545 Girolamo Cardano, an Italian physician, mathematician, and philosopher, published a book, Ars magna, or the Rules of Algebra (picture), which included the solutions to cubic and quartic equations, for which Cardano is perhaps best known today. Rearranging the letters of “ars magna” yields “anagrams”, another 16th century phenomenon, in English at least—the first recorded reference to the word given in the Oxford English Dictionary is from 1589. more…

Neel Sharma and Chaoyan Dong: Coalition in medical education

21 Aug, 15 | by BMJ

Trudie Roberts and Ronald Harden authored a commentary earlier this year which focused on enhancing existing collaborations to solve the challenges in medical education. We wanted to share our insights.

There is certainly need for improvement as alluded to in Roberts’s and Harden’s article and whilst significant steps have already taken place in this regard, more can be done. Without pushing the boundaries currently in place there is no chance to better what we already know or do. Currently medical schools in the UK have different exiting exams for their students. And whilst they are expected to follow the GMC’s Tomorrow’s Doctors dictum, how can we truly quantify this when disparity exists? The Medical Schools Council Assessment Alliance MSC AA is an example of a coalition, particularly in regard to their unifying situational judgement and prescribing safety assessments. Yet we are still not on the same page as several of the Royal Colleges, where all trainees are expected to sit the same standardized exam depending on the specialty they choose. The GMC is keen to introduce a national licensing exam and we feel that this could certainly aid in ensuring uniform exiting standards, similar to the USMLE in the United States. However are exams by themselves the be all and end all? There is currently some discussion regarding entrustable professional activities (EPAs), which are being sold as a grade up from current competency based tasks. With EPAs candidates are only deemed to be entrusted to perform a particular task without supervision if they have demonstrated that they are able to do it over a repeated and prolonged duration. The AAMC currently ensures exiting students should be deemed capable of performing a set of core EPAs prior to residency helping to ensure patient safety during the transition. more…

Phillippa Hentsch: A new way of paying for urgent and emergency care services

21 Aug, 15 | by BMJ

Phillippa Hentsch-Different parts of the urgent and emergency care (UEC) pathway are paid for in different ways. Acute and specialist facilities are predominately funded through the national tariff, whereas UEC services offered by mental health and community trusts—such as rapid response, crisis teams, and psychiatry liaison services—are paid predominately through block contracts. For commissioners and providers attempting a system wide redesign of UEC services, this patchwork of payment approaches gives you a headache. more…

Lara Gautier: August 2015—a paroxysm of environmental health incidents caused by industrial activity

20 Aug, 15 | by BMJ

Lara GautierThe Animas river in Colorado, the Moskva river south of Moscow, and Tianjin. What do these three geographic areas have in common? They have all been deeply affected by industrial hazards in August 2015.

5 August: In Colorado, agents from the US Environmental Protection Agency (EPA) accidentally unleashed 3m gallons of toxic mine waste into the Animas river, which feeds the Colorado River and many Southern US cities. The dam that was holding the waste burst open during investigative efforts by the EPA, who were looking at stopping toxic leakage from the Gold King Mine. The acidic, heavy metal laden waste has coloured the river yellow for days, raising legitimate concerns from Navajo communities and residents living along the river. The president of Navajo Nation, Russell Begaye, has highlighted how “the spill has impacted us religiously, emotionally, financially.” The Guardian reports that the area was heavily mined for gold and silver for decades. more…

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