As an unschooled observer of the money markets, I have been struggling in recent months to understand what anything is actually worth. In healthcare, there is a similar problem, though it makes for rather less exciting headlines. All NHS procedures have to be costed to the last penny, and reported on in “completed care episodes”. […]
Continue Reading →Should the NHS underwrite cosmetic surgery done abroad?
The British Association of Plastic Reconstructive and Aesthetic Surgeons have issued the results of a questionnaire asking surgeons if they have had to give emergency treatment to people who have had cosmetic surgery abroad. Unsurprisingly, the answer was yes. This is only the tip of an iceberg – there have been reports of patients returning […]
Continue Reading →Breast cancer: to screen or not to screen?
A very interesting paper just published in the Archives of Internal Medicine. The study followed women before and after the introduction of a breast screening programme in Norway. They were compared to a control group of women who did not take part in the screening programme, but who would have been, had the programme been started in […]
Continue Reading →Hard choices on hormone replacement therapy
When I was at medical school, hormone replacement therapy was not just the treatment of choice for the flushes and sweats of menopause. It was also thought to reduce the risk of heart attacks, strokes, dementia, colon cancer, bone and even teeth loss. Yet over the past few years new research has made many doctors […]
Continue Reading →Is paracetamol still safe for children?
Medical lore has created something of a cult around the measurement of children’s temperatures. A fever seems to be something which is suspected and then recorded, swiftly followed by the administration of medicine to “bring it down”. Some confessions. My home medical kit isn’t up to much. At one point it did contain a thermometer, […]
Continue Reading →The President’s records
When it was announced that both the presidential candidates were allowing sight of medical information about them to be read and reported on by journalists, I was slightly perturbed. Sure, I could see that perhaps the knowledge that one had no outstanding concerns with their health might – might – have some kind of relevance […]
Continue Reading →Why randomised trials still work best
The only thing separating reiki and reflexology from rational medicine and progress is evidence. And what evidence-based aficionados like me love best is the randomised controlled trial, the process by which most drugs and treatments aspire to be tested. But are we now hearing its death rattle? In a recent lecture at the Royal College […]
Continue Reading →‘Normal’ cholesterol: to treat or not to treat?
Much ado with a new paper published by the New England Journal of Medicine . This study was placebo controlled and focused on treating people with “normal” cholesterol but a high “c-reactive protein” (a marker of inflammation) with rosuvastatin (which is not a new statin as some media outlets have reported, but one already in use). Reports have […]
Continue Reading →“Professionals” in pay
“GlaxoSmithKline is to make public the level of advisory fees it offers to doctors and medical academics, and will strictly cap the payments they can receive in the US to $150,000 (£88,000) a year each. Andrew Witty, chief executive of the UK-based pharmaceutical company, said he was introducing tougher new rules to impose a cap […]
Continue Reading →A CT scan is not the answer
Free newspapers, a takeaway menu, special offers from the supermarket and, in the pile of mail cascading on to the doormat, a glossy leaflet from a health clinic, advertising a special check-up service. “Put your mind at ease with a health check from Lifescan, the UK’s leading provider of private CT assessments,” it said, alongside […]
Continue Reading →