w Don Berwick - you can break the rules to help patients By feeds.bmj.com Published On :: Fri, 15 Jun 2018 12:52:40 +0000 Don Berwick, president emeritus of the Institute of Healthcare Improvement, and former Administrator of the Centers for Medicare and Medicaid Services. In this conversation he discusses how he went from being a paediatrician to running Medicare for Obama, how we can create headroom in stressed systems, and breaking the rules to make things better... Full Article
w When an investigative journalist calls By feeds.bmj.com Published On :: Fri, 22 Jun 2018 17:11:23 +0000 At Evidence Live this year, the focus of the conference was on communication of evidence - both academically, and to the public. And part of that is the role that investigative journalism has to play in that. At the BMJ we’ve used investigative journalistic techniques to try and expose wrong doing on the part of government and industry - always... Full Article
w Doctors and vets working together for antibiotic stewardship By feeds.bmj.com Published On :: Wed, 11 Jul 2018 15:00:36 +0000 Doctors and the farming industry are often blamed for overuse of antibiotics that spurs the growing problem of antimicrobial resistance - but the professions are using different methods to combat resistance and reduce overuse. In this roundtable, we bring medics and vets together to discuss the problem - where antibiotic resistance arises, how... Full Article
w What does the public think of the NHS? By feeds.bmj.com Published On :: Thu, 12 Jul 2018 17:02:32 +0000 It’s been quite a year for the NHS - it just turned 70, had a winter crisis like never before, got over junior doctor strikes, but then was hit by a series of scandals about breast screening, and now opiate prescriptions. At the same time, we’ve seen demonstrations in favour of the service and even widespread public backing for more money. So... Full Article
w 15 seconds to improve your workplace By feeds.bmj.com Published On :: Fri, 27 Jul 2018 16:23:56 +0000 15s30m is a social movement to reduce frustration & increase joy - the idea is to spend 15 seconds of your time now, and save someone else 30 minutes down the line. To talk about their movement we're joined by the founders, Rachel Pilling, consultant ophthalmologist, and Dan Wadsworth, transformation manager - both from Bradford Teaching... Full Article
w Have we misunderstood TB's timeline? By feeds.bmj.com Published On :: Thu, 23 Aug 2018 09:46:24 +0000 The number of people estimated to be latently infected with TB - that is infected with TB, which has not yet manifested symptoms - is around 2 billion. That is 1 in 3 people on the planet are infected by the bacteria. The World Health Organization’s website notes that on average 5-10% of those infected with TB will develop active TB. That number... Full Article
w Preventing Overdiagnosis 2018 - part 2: What opened your eyes to overdiagnosis? By feeds.bmj.com Published On :: Fri, 31 Aug 2018 18:27:16 +0000 The concept of overdiagnosis is pretty hard to get - especially if you’ve been educated in a paradigm where medicine has the answers, and it’s only every a positive intervention in someone’s life - the journey to understanding the flip side - that sometimes medicine can harm often takes what Stacey Carter director of Research for Social Change at... Full Article
w How often do hospital doctors change long term medication during an inpatient stay? By feeds.bmj.com Published On :: Fri, 14 Sep 2018 18:00:24 +0000 More than ½ of patients leave hospital with changes to four or more of their long-term medications - but how appropriate are those changes? New research published on bmj.com looks at antihypertensive medication prescription changes to try and model that - and found that more than half of intensifications occurred in patients with previously well... Full Article
w How to taper opioids By feeds.bmj.com Published On :: Thu, 11 Oct 2018 08:10:59 +0000 There is very little guidance on withdrawing or tapering opioids in chronic pain (not caused by cancer). People can fear pain, withdrawal symptoms, a lack of social and healthcare support, and they may also distrust non-opioid methods of pain management. This can mean that patients receive repeat opioid prescriptions for extended periods of... Full Article
w What's it like to live with a vaginal mesh? By feeds.bmj.com Published On :: Fri, 12 Oct 2018 16:52:37 +0000 What can we learn from the shameful story of vaginal mesh? That thousands of women have been irreversibly harmed; that implants were approved on the flimsiest of evidence; that surgeons weren’t adequately trained and patients weren’t properly informed; that the dash for mesh, fuelled by its manufacturers, stopped the development of alternatives;... Full Article
w How does lifestyle affect genetic risk of stroke? By feeds.bmj.com Published On :: Tue, 30 Oct 2018 13:35:23 +0000 Cardiovascular factors are associated with risk of stroke - and those factors can be mediated by lifestyle and by genetic make up. New research published by The BMJ sets out to explore how these risks combine, and we're joined on the podcast by two of the authors - Loes Rutten-Jacobs, senior postdoctoral researcher at the German Center for... Full Article
w How much oxygen is too much oxygen? By feeds.bmj.com Published On :: Thu, 01 Nov 2018 18:05:18 +0000 As the accompanying editorial to this article says, "oxygen has long been a friend of the medical profession Even old friendships require reappraisal in the light of new information." And that’s what a new rapid reccomendation - Oxygen therapy for acutely ill medical patients - does. To discuss we're joined by two of the authors, Reed Simieniuk,... Full Article
w HAL will see you now By feeds.bmj.com Published On :: Mon, 05 Nov 2018 14:17:12 +0000 Machines that can learn and correct themselves already perform better than doctors at some tasks, but not all medicine is task based - but will AI doctors ever be able to have a therapeutic relationship with their patients? In this debate, Jörg Goldhahn, deputy head of the Institute for Translational Medicine at ETH Zurich thinks that the... Full Article
w Acceptable, tolerable, manageable - but not to patients. How drug trials report harms. By feeds.bmj.com Published On :: Mon, 19 Nov 2018 18:02:11 +0000 You’ll have read in a clinical trial “Most patients had an acceptable adverse-event profile.” Or that a drug “has a manageable and mostly reversible safety profile.” And that “the tolerability was good overall.” In this podcast, Bishal Gyawali (@oncology_bg) joins us to describe what events those terms were actually describing in cancer drug... Full Article
w Making multisectoral collaboration work By feeds.bmj.com Published On :: Fri, 07 Dec 2018 22:30:54 +0000 A new collection of articles published by The BMJ includes twelve country case studies, each an evaluation of multisectoral collaboration in action at scale on women’s, children’s, and adolescent’s health. Collectively these twelve studies inform an overarching synthesis and accompanying commentaries, drawing together lessons learned in... Full Article
w Women in medicine at Christmas By feeds.bmj.com Published On :: Fri, 21 Dec 2018 15:44:51 +0000 2018 will go down in history as a year of reckoning as the year that that some men’s behaviour came back to bite them. The continuing impact of #MeToo across the world has prompted another round of thinking about women’s experiences in medicine, which can be seen this year’s christmas journal In this podcast, Esther Choo and Eleni Lenos, join us... Full Article
w How Coca-Cola shaped obesity science and policy in China By feeds.bmj.com Published On :: Wed, 09 Jan 2019 17:25:25 +0000 Susan Greenhalg is a research professor of chinese society in Harvard’s department of anthropology - not a natural fit for a medical journal you may think, but recently she has been looking at the influence of Coca Cola on obesity policy in China. She has written up her investigation in an article published on bmj.com this week, and joins us in... Full Article
w HIV - everything you wanted to know about PeP and PreP By feeds.bmj.com Published On :: Tue, 15 Jan 2019 23:12:27 +0000 We have had two articles published recently on bmj.com, looking at drug prevention of HIV; PeP - Post-exposure Prophylaxis and PreP - Pre-exposure Prophylaxis, neither prevent the virus from entering the body, but they do prevent the infection from taking hold. There are lots of questions that doctors have about these - what are the risk... Full Article
w Talk evidence - TIAs, aging in Japan and women in medicine By feeds.bmj.com Published On :: Wed, 23 Jan 2019 10:16:29 +0000 In this EBM round-up, Carl Heneghan, Helen Macdonald and Duncan Jarvies are back to give you an update Dual vs single therapy for prevention of TIA or minor stroke - how does the advice that dual work better translate in the UK? Carl explains why Japan can teach us to get active and, how GPs can use that information to "drop a decade" in... Full Article
w Goran Henriks - How an 80 year old woman called Esther shaped Swedish Healthcare By feeds.bmj.com Published On :: Fri, 25 Jan 2019 06:11:19 +0000 Jönköping has been at the centre of the healthcare quality improvement movement for years - but how did a forested region of Sweden, situated between it's main cities, come to embrace the philosophy of improvement so fervently? Goran Henriks, chief executive of learning and innovation at Qulturum in Jönköping joins us to explain. He also tells... Full Article
w Should we be screening for AF? By feeds.bmj.com Published On :: Thu, 14 Feb 2019 17:38:45 +0000 Current evidence is sufficient to justify a national screening programme, argues Mark Lown clinical lecturer at the University of Southampton, but Patrick Moran, senior research fellow in health economics at Trinity College Dublin, thinks there are too many unanswered questions and evidence from randomised trials is needed to avoid... Full Article
w Nuffield 2019 - How can the NHS provide a fulfilling lifelong career By feeds.bmj.com Published On :: Wed, 06 Mar 2019 18:23:54 +0000 More doctors are choosing to retire early, doctors who take career breaks find it hard to return to practice, and doctors at all stages of their careers are frustrated by the lack of support given to training and development in today’s NHS. Each year the BMJ holds a roundtable discussion at the Nuffield Summit - where health leaders come... Full Article
w Passing on the secret knowledge of loop diuretics By feeds.bmj.com Published On :: Fri, 15 Mar 2019 17:07:15 +0000 In every generation there are a few that know the secret; the counterintuitive effects of loop diuretics. In this podcast Steven Anisman, cardiologist at the Dartmouth Hitchcock Department of Cardiovascular Medicine, joins us to explain about the threshold effects of these drugs, and why that might change the way in which you think about... Full Article
w Is opt-out the best way to increase organ donation? By feeds.bmj.com Published On :: Fri, 22 Mar 2019 16:43:46 +0000 As England’s presumed consent law for 2020 clears parliament, Veronica English, head of medical ethics and human rights at the BMA, say that evidence from Wales and other countries shows that it could increase transplantation rates. But Blair L Sadler, physician and senior adviser to California State University, consider such legal changes a... Full Article
w Applying new power in medicine By feeds.bmj.com Published On :: Mon, 01 Apr 2019 11:41:04 +0000 Change requires the application of power - the way in which individuals can accrue power has shifted in our digitally connected world. Traditional ways of influencing change in healthcare (getting the chief executive on side, having a quiet chat with the medical director) are not the only way to build a momentum. Henry Timms - author of “New... Full Article
w How to have joy at work By feeds.bmj.com Published On :: Fri, 05 Apr 2019 15:56:02 +0000 Jessica Perlo is the Director for Joy at Work at the Institute for Healthcare Improverment, and James Mountford is direct or of quality at the Royal Free London NHS Foundation Trust. Together they joined us at the International Forum on Quality and Safety in Healthcare to discuss joy at work - what that concept actually means, and practically,... Full Article
w Introducing Sharp Scratch - our new podcast for students and junior doctors By feeds.bmj.com Published On :: Fri, 26 Apr 2019 16:22:39 +0000 Here's a taster for our new student podcast - Sharp Scratch. We're talking about the hidden curriculum, things you need to know to function as a doctor, but are rarely formally taught. This is a taster - if you enjoy, subscribe! https://podcasts.apple.com/gb/podcast/student-bmj-podcast/id331561304 Sharp Scratch episode 1: Surviving the night... Full Article
w Helping parents with children who display challenging behaviour By feeds.bmj.com Published On :: Fri, 17 May 2019 14:50:07 +0000 Looking after a young child is hard enough, but when that child has learning difficulties and displays challenging behaviour - the burden on parents can be extreme. That behaviour may prompt a visit to the doctor, and in this podcast we’re talking about how parents can be supported in that - what services are available. We’ll also be discussing... Full Article
w What caused the drop in stroke mortality in the UK By feeds.bmj.com Published On :: Thu, 23 May 2019 10:12:07 +0000 Stroke mortality rates have been declining in almost every country, and that reduction could result from a decline in disease occurrence or a decline in case fatality, or both. Broadly - is that decline down to better treatment or better prevention. Olena Seminog, a researcher, and and Mike Rayner, professor of population health, both from the... Full Article
w Finding out who funds patient groups By feeds.bmj.com Published On :: Wed, 29 May 2019 16:32:22 +0000 We’ve been banging the drum about transparency of payment to doctors for years - we’ve even put a moratorium on financial conflicts of interest in the authors of any of our education articles. Not because we think that all doctors who receive money from industry are being influenced to push their agenda - but because we have no way of telling when... Full Article
w Tech and the NHS - A tale of two cultures By feeds.bmj.com Published On :: Mon, 03 Jun 2019 17:31:28 +0000 The NHS is about caring for people, free at the point of care, creating a safety net which catches the most vulnerable. Tech has been defined by the facebook maxim "move fast, break things" - looking to disrupt a sector, get investment and move on. We want to be able to harness the potential utility of digital tech in the NHS - but how can those... Full Article
w What Matters To You Day By feeds.bmj.com Published On :: Thu, 06 Jun 2019 07:02:20 +0000 It's What Matters To You day - #wmty - and in this podcast Anya de Iongh, The BMJ's patient editor, and Joe Fraser, author of Joe's Diabetes who works at NHS England on personalised care, get together to discuss what personalised care actually means, how it changes the ways in which patients and health professionals interact, and how it can be... Full Article
w Working as a team, and combating stress, in space By feeds.bmj.com Published On :: Tue, 18 Jun 2019 15:04:19 +0000 Nicole Stott is an engineer, aquanaut and one of the 220 astronauts to have lived and worked on the International Space Station. In a confined space, under huge pressure, with no way out, it's important that teams maintain healthy dynamics, and individuals can manage their stress adequately, and in this podcast Nicole explains a little about... Full Article
w I have never encountered an organisation as vicious in its treatment of whistleblowers as the NHS By feeds.bmj.com Published On :: Thu, 04 Jul 2019 10:23:06 +0000 Margaret Heffernan has thought a lot about whistleblowing, and why companies don't respond well to it. She wrote the "Book Wilful Blindness: Why We Ignore the Obvious at our Peril". In this podcast she talks about how culture, and groupthink, leads to a culture where whistleblowers are ignored, and why the NHS needs to change the way it treats... Full Article
w Fertility awareness based methods for pregnancy prevention By feeds.bmj.com Published On :: Sat, 13 Jul 2019 17:38:01 +0000 Fertility awareness based methods of contraception are increasingly being used for pregnancy prevention. In the US, the proportion of contraceptive users who choose such methods has grown from 1% in 2008 to approximately 3% in 2014. Relative to other methods of pregnancy prevention, however, substantial misinformation exists around fertility... Full Article
w Vaping deaths - does this change what we think about public health messages By feeds.bmj.com Published On :: Thu, 12 Sep 2019 16:58:18 +0000 This week the Trump administration has banned the sale of flavoured vapes in the USA. The reason for that is the sudden rash of cases of pulmonary disease, including deaths, linked to vaping. The mechanism by which vaping may be causing damage to the lungs is as yet unclear, and our understanding is hampered by the heterogeneous nature of the... Full Article
w Climate change will make universal health coverage precarious By feeds.bmj.com Published On :: Tue, 24 Sep 2019 14:26:52 +0000 The BMJ in partnership with The Harvard Global Health Institute has launched a collection of articles exploring how to achieve effective universal health coverage (UHC). The collection highlights the importance of quality in UHC, potential finance models, how best to incentivise stakeholders, and some of the barriers to true UHC. One of those... Full Article
w A new way to look at behaviour change in UK GPs By feeds.bmj.com Published On :: Tue, 08 Oct 2019 14:52:42 +0000 In quality improvement, measurement is seen as a key driver of change - how well do you know you’re doing, if you can’t actually measure it. So, when something changes in the NHS (say a new guideline) how can you tell how quickly that’s filtering down to the front line. Ben goldacre, from the Nuffield Department of Primary Care Health Sciences... Full Article
w How Blockchain could improve clinical trial transparency By feeds.bmj.com Published On :: Sat, 12 Oct 2019 13:06:50 +0000 Blockchain is the digital technology that underpins cryptocurrencies such as bitcoin, and has been proposed as the digital panacea of our times. But Leeza Osipenko, from the London School of Economics, has thought about how it could actually be used in clinical trials, and what else would need to change in our regulatory environment to make that... Full Article
w Statins for primary prevention - How good is the evidence By feeds.bmj.com Published On :: Mon, 21 Oct 2019 10:12:15 +0000 Statins are now the most commonly used drug in the UK and one of the most commonly used medicines in the world, but debate remains about their use for primary prevention for people without cardiovascular disease. Paula Byrne from the National University of Ireland Galway, joins us to talk about the evidence of benefit for low risk individuals,... Full Article
w 20 Arnav Agarwal By feeds.bmj.com Published On :: Tue, 22 Oct 2019 22:59:17 +0000 This week, Dr Arnav Agarwal joins Ray to share the perspective and experiences of a young, recently graduated doctor working in a busy, metropolitan hospital. Despite the long shifts and demanding environment, Arnav makes time and space to reflect on work, life and mortality through his thought-provoking poetry and volunteer work. Full Article
w Reversing our preconceptions about where innovation comes from By feeds.bmj.com Published On :: Thu, 14 Nov 2019 16:51:19 +0000 Reverse innovation may sound like some attempt to return to the dark ages - but it has a specific meaning, especially when it comes to med-tech. It’s about where we look for innovation - and overturning our preconceived ideas of where new ideas come from. Mark Skopec, and Matthew Harris - both from Imperial College London are two of the authors... Full Article
w Behind the campaign promises - what the NHS means for the election By feeds.bmj.com Published On :: Thu, 05 Dec 2019 19:09:30 +0000 UK general election has been called - polling day is on the 12th of December, and from now until then we’re going to be bringing you a weekly election-themed podcast. We want to help you make sense of the promises and pledges, claims and counter-claims, that are being made around healthcare and the NHS out on the campaign trail. This week we're... Full Article
w Michael West - GMC Report On Wellbeing By feeds.bmj.com Published On :: Fri, 10 Jan 2020 15:02:33 +0000 Michael West is professor of organisational psychology, at Lancaster University, and co-author of a new GMC report into the wellbeing of NHS staff. The review he led together with the clinical psychiatrist Denise Coia, focused on primary interventions related to workplace factors and the systems that doctors work in, rather than secondary... Full Article
w Writing a good outpatient letter means addressing it to the patient By feeds.bmj.com Published On :: Fri, 07 Feb 2020 11:31:30 +0000 In many countries (including the UK and Australia) it is still common practice for hospital doctors to write letters to patients’ general practitioners (GPs) following outpatient consultations, and for patients to receive copies of these letters. However, Hugh Rayner, consultant nephrologist, and Peter Rees, former Chair of the Academy of... Full Article
w David Williams - everyday discrimination is an independent predictor of mortality By feeds.bmj.com Published On :: Thu, 13 Feb 2020 12:44:12 +0000 There comes a tipping point in all campaigns when the evidence is overwhelming and the only way to proceed is with action. According to David Williams, it’s time to tackle the disproportionate effects of race on patients in the UK. David Williams, from Harvard University, developed the Everyday Discrimination Scale that, in 1997, launched a new... Full Article
w Why we are failing patients with multimorbidity By feeds.bmj.com Published On :: Thu, 05 Mar 2020 14:54:02 +0000 We know that the number of people living with multiple health conditions is rising year on year, and yet training, guidelines, organisations and physical spaces in healthcare still largely focus on single diseases or organ systems. The means that patients in the NHS are often treated as if their conditions exist in isolation, and that their care... Full Article
w Cycling - Does the health benefit outweigh the accident risk (in the UK) By feeds.bmj.com Published On :: Thu, 12 Mar 2020 16:22:11 +0000 We all know we should be doing more exercise, and one way to do that is by active commuting - journeying to work on foot or by bike. One thing preventing people from taking up cycling is the fear of being involved in road traffic accidents, and that the risk isn't worth the benefit of the extra exercise. It’s even more confusing when air... Full Article
w WHO's response to covid-19 By feeds.bmj.com Published On :: Sun, 05 Apr 2020 17:01:53 +0000 We knew a pandemic was coming at some point - it’s kind of why we have the WHO. We have had various smaller scale tests of the international response to an infectious disease outbreak - Ebola in west africa being the most recent. After that, reports criticised the WHO's response - citing problems around the swiftness of their action, the lack of... Full Article
w Wellbeing - Some advice on working in PPE By feeds.bmj.com Published On :: Wed, 08 Apr 2020 17:38:56 +0000 Wellbeing might not seem the obvious place to talk about PPE - but lack of appropriate PPE is causing healthcare staff a great deal of stress now. Mary Brindle is a pediatric surgeon and the director of The EQuIS (Efficiency Quality Innovation and Safety) Research platform at Alberta Children’s hospital. In this podcast she reflects on the use... Full Article