Hello. I am a GP in Glasgow and write for various bits of the media mainly about evidence based medicine; I write regularly for the British Medical Journal, broadcast for Radio 4’s Inside Health, and often for other newspapers and journals.
I am hoping that this blog will be a forum for discussion of some of the myriad problems in healthcare, especially the ones that I think don’t always get a fair hearing – and some that don’t get heard much at all outside of the corridors of the NHS.
For example, some of my recurrent concerns are: Why do we so often ignore the evidence for what healthcare interventions work and what don’t? Does continuity of care matter? Is there any proof that market based provision of healthcare is more efficient? Is the National Institute for Clinical Excellence an example of rational rationing or does it just ascribe a financial worth to life? Should people ever use complementary therapies? Who are independent sources of healthcare information? Why are pharmaceutical companies not legally compelled to publish all of their clinical trial data? Should patients trust doctors? Are there any checkups worth having? Are the results of clinical trials fairly reported in the popular media? How should doctors ethically use the placebo effect? Is there such a thing as modern medical professionalism? Are private finance initiatives truly the biggest waste of money the NHS is bankrolling? Is patient satisfaction a good measure of how good a doctor is? Should universities ever employ PR firms to publicise medical research findings? Is the NHS “a gift economy”? Is it ethical for pharmacists to sell ‘treatments’ that have no, or little, basis in evidence? Can nurses do a doctor’s job better?
I am, you’ll be glad to know, not planning to answer all at once.
And so that I am being honest about my own biases; here they are. I believe whole heartedly in the ethos of the NHS. I get extremely, coffee-spillingly irritated when the radio is on and I hear politicians meddling and muddling in the NHS (again). I get upset when people are misled into overhyped hopes. I hope, and think that most health professionals are motivated by vocation and that most hold to professional values.
Update, November 2010 : I don’t accept, and have never accepted, external advertising or fees for guest posts on this site.
Thank you for visiting
UPDATE August 2012
1) Please, please please.
If you are an editor or journalist, and want to speak to me, please send an email, to email@example.com. If I can help, I will respond as quickly as I can.
PLEASE do not phone my practice. I won’t respond any sooner, and the staff are all busy doing NHS work.
2) PR companies. I have never been paid by any company to do any kind of promotional work. That’s not changing anytime soon. Please don’t waste your time on me.
Update September 2012
Conflicts of interest (which I hope are potential rather than actual conflicts, but disclosed out of a wish to be open)
– I work as a NHS GP, and I am also an undergraduate tutor at Glasgow University
-I have written a book and write and broadcast for the lay and medical press about medical and related issues, and am paid for this.
-I have done some work for Which?, the consumer organisation, mainly around evidence based practice in healthcare, and I hope to do more in the future.
-I have never done any work for any PR company, or received money from PR or pharmaceutical companies for work or consultancy. When I was a junior doctor I did eat drug company sandwiches until I saw the light, and wrote this http://www.guardian.co.uk/society/2004/may/25/health.medicineandhealth1 about my experiences.
– I have given lots of talks for free to various organisations, and am happy to do so, and sometimes (rarely) I am paid for these, but it has never been a pharmaceutical or PR company funding (for example, one was on workshops I ran on evidence for GPs, which was paid by the GPs themselves.) If it takes me a lot of time to prepare I think this is okay. (Update, December 2012; I have on one occasion received a fee for taking part in a round table event, organised by a newspaper, to discuss the evidence for telehealth, and since it took me a day to get there and back I thought that was fair enough.)
– I have donated time to various projects which share my objectives such as Sense about Science and I hope to continue this in the future.
– I donate a small amount of money monthly to Keep Our NHS Public.
Update, October 2013
I am a now a patron of Healthwatch, replacing Susan Greenfield.
I’ve also been paid to write a lecture for a (non pharma sponsored) conference ( it took hours.)
I have been a member of Medact since I was a student. This is their relaunch .
Update November 2013
I was elected to the national council of the RCGP.
Update January 2014
Unpaid advisory committee member to the Progress Educational Trust’s public engagement project ‘Breast cancer: Genetics, chances and choice’s, which is supported by the Wellcome Trust.
I hope to
– work on the problems of pharma and commercial sponsorship (conference, building, Emma’s diary.)
– COIs ; and making these and as many council papers as possible open and transparent.
– address the problems of overdiagnosis and overtreatment.
-How can we look after GPs needs; most doctors start with a vocation and a want to help. We end up delivering a evidence free political agenda. This causes me stress and distress. Lots of people have told me they feel the same. Looking after doctors is also about looking after patients. But who is looking after us?
On advisory group; Supporting Informed Healthcare Choices in Low Income Countries (SIHCLIC) (unpaid)
Advisory panel member to Progress Trust’s Breast Cancer: Genetics, Chances and Choices project (unpaid)
Update June 2014
I do appreciate being asked to give talks; I enjoy doing them, and it’s a privilege to be invited. Over the last year I’ve been struggling more with time. I’m a part time GP but the days I am not at work are days not just for writing but for being with my family. I don’t have a PA or an agent – it’s just me! Please forgive me if I can’t manage – at the moment it feels like I am dropping balls rather than juggling them.
Update Dec 14
I am chair of the RCGP overdiagnosis standing group.
Lots of work on this to follow.
– I would be totally unable to accept any kind of honour system thing, please don’t waste your time on nominations. I don’t believe in them. If you are nominating anyone, think about the people at things like Coderdojo, a fantastic free coding club for kids run by volunteers, or the local karate teachers who give up evenings for no pay in order to teach children their craft.
-If you are a journalist and want to speak to me and have my phone number, please remember that I am very likely to be doing NHS work during 7am-6pm. I can’t spend time on the phone for non NHS work. If you drop a text, I will reply just as fast as I would have anyway. Thanks.
-New book from Pinter and Martin, called Living with Dying. It’s here.
member of the National Institute for Health Research Dissemination Centre Advisory Group . This gets reimbursed at 150 per meeting, and I will be able to go to one meeting this year I think, so will be emailing back suggestions or comments if I can without attending the meetings.
Also in December I made a social investment of 500 in Who Made Your Pants? which means I can no longer say how great their knickers are.
I gave a talk to FOCUS annual meeting, who are part of the health insurance industry, in Edinburgh. There and back on the train, and they made a donation to Mary’s Meals for me, and I paid my own train fare. They also send flowers to my mum who looked after the children for me. I talked about why I encourage people who are signed off work to take part in activities and see people as best they can – a common misconception is that if you are off sick you should be at home and doing very little. Not at all.
BMJ column continues, free to access