The BMJ Today: Appraisals, carers, and cognitive enhancement

appraisal• What is appraisal good for?
As big finance companies such as Accenture are reported to be scrapping formal appraisal systems for their employees, Margaret McCartney, our Glasgow based weekly GP columnist, also takes aim. “Appraisal is a false god. It is a waste of time and a misuse of resources,” she writes, slamming it for being “time wasting, navel gazing, and expensive” and criticising the insufficient consideration that has been given to determining whether it even works.

hospital_ward_older• How carers can help on the wards
Our other weekly columnist, the Reading based geriatrician and hospital doctor David Oliver, in his latest offering, has ruminated on how inpatients’ carers can improve hospital care. “Involving carers early and often is crucial. We learn more from them than they can from us. And they provide continuity in an often fragmented system.” John’s Campaign promotes carers staying on wards as partners in care. “Since 2014 around 100 UK hospitals have signed up to it, scrapping visiting restrictions or issuing ‘carers’ passports,’” Oliver writes.

adderall• How to be more smart
And our occasional observations columnist, Krishna Chinthapalli, an advanced trainee in neurology in Sydney, Australia, reflects on the fortune to be made from “smart drugs” and other products marketed to improve cognition. “Crosswords are being replaced by brain training games, now a billion dollar industry,” he writes. “Overstated claims by software companies led to a consensus statement last year by more than 60 neuroscientists warning that evidence was sparse and of poor quality. They concluded, ‘If an hour spent doing solo software drills is an hour not spent hiking, learning Italian, making a new recipe, or playing with your grandchildren, it may not be worth it.’”

Where do you stand on these issues? Let us know by sending a rapid response to any article on We republish the most interesting and useful as formal letters to the editor.

Richard Hurley, features and debates editor, The BMJ.  Follow on Twitter, @rich_hurley.