“The operation was a success but the patient died.” This old jibe, usually aimed at surgeons taking a narrow technical view of the outcome, seems out of date now. There […]
Too much medicine
Helen Macdonald: Fixing evidence based medicine
Love it or hate it—we must all consume evidence. Now is your chance to have your say on what its future should be like. Yesterday the Centre for Evidence Based Medicine at Oxford […]
Avril Danczak: When is a disease not a disease?
Most GPs will recognise the dispiriting conversation that can happen when a patient discovers that they have Chronic Kidney Disease Stage 3 (CKD). “A disease? Where did I catch it […]
Richard Smith: Doctors phishing for phools
In their influential book Phishing for Phools: The Economics of Manipulation and Deception two Nobel prize winners, George A Akerlof and Robert J Shiller, describe how businesses profit from exploiting […]
Avril Danczak: Selling statins to patients
“Are you ashamed of yourself now?” This was a patient’s response when her doctor wanted to start her on a statin. Every week I work with up to 30 General […]
Georg Röggla: Choosing wisely in Germany
I attended the annual convention of the German Society of Internal Medicine DGIM (Deutsche Gesellschaft für Innere Medizin) in Mannheim this week. The main focus of this congress is transferring […]
Saurabh Jha: Saving Normal
The iconoclastic psychiatrist Thomas Szasz said that mental illness was metaphorical, not real, because mental diseases lacked biological substrates. The absence of a substrate predisposes psychiatry to overdiagnosis and avoiding overdiagnosis is […]
Navjoyt Ladher: Preventing Overdiagnosis 2015—winding back the harms of too much medicine
“Medical science has made such tremendous progress that there is hardly a healthy human left”—Aldous Huxley Today sees the start of the third annual Preventing Overdiagnosis conference, this year hosted […]
Jack O’Sullivan: Managing overdiagnosis
“Hardly more effective than a coin toss.” The damming words from the discoverer of prostate specific antigen (PSA) poignantly reflect the controversies of prostate cancer screening. In fact, Richard J […]
Helen Macdonald: Discussing clot busters for stroke in the mainstream media
A recent episode of File on 4, entitled “Treating Stroke: The Doctor’s Dilemma,” discusses the latest on the only clot buster for ischaemic stroke—alteplase—and touches on broader debate that will […]