When I was a medical student, I went to lectures which told me that HRT was going to stop everything from dementia to heart attacks to teeth falling out. I hardly prescribe it now, such are the hazards, especially of breast cancer, and given that the long term benefits are not what we were sold. […]
Continue Reading →Tell me the truth about Fit Notes
So the big idea was that people who were off work due to illness might be able to do some work, perhaps not their regular work, or perhaps people returning to work while recovering from illness might be better having a graduated return. Rather than simply signing people off work while ill and then back […]
Continue Reading →Religious doctors and death
A paper in the Journal of Medical Ethics is suggesting that non religious doctors “were more likely than others to report having given continuous deep sedation until death, having taken decisions they expected or partly intended to end life” . This seems to have caused some furore on Radio 4 this am with a discussion about whether […]
Continue Reading →Patient choice and doctor-mediated injury
So here’s patient choice for you. Rugby player, mid-match, asks his doctor to have a small cut made in his lip. Doctor says no. He asks again. So she makes a small injury, which means that he can be substituted and thus has repercussions on the competition: Dr Wendy Chapman, now obviously regretful of her actions now […]
Continue Reading →Is your doctor a ‘high flyer’ or a ‘rule bound’?
The latest on AstraZeneca, who are having to pay 198 million US dollars to patients who have developed diabetes on the anti psychotic drug quetiapine is only one bit of a long story. The challenge being made is that the weight gain and tendency to diabetes for some patients was known by AstraZeneca but not acknowledged fully on the […]
Continue Reading →The Kings Fund on GP referral management centres
I’m not quite sure what I think of the King’s Fund: some of their papers seem to me to miss the point: academic distance from reality can be damaging. They have examined Referral Management Centres and concluded that they aren’t very good, which was obvious to GPs but lost on politicians. Quite interesting. What I […]
Continue Reading →The health care of detained asylum seekers
..is not being adequately met. Here’s an article just out in the BMJ about the situation. This is one situation which I do think would be helped by public pressure….
Continue Reading →Will GP commissioning help patients get better?
I think not. I’ve spent a bit of time reading the new White Paper and associated fluff, I conclude that there are possibly two good things in it. I’ll get to them. But, oh, the jargon! And the rest of it! What on earth does ‘equity and excellence: liberating the NHS’ actually mean? I’m really […]
Continue Reading →Homeopathy: witch hunting or waste of money
etc, etc. I am getting quite bored of the homeopathy debate. It should have moved on a bit, really. So here is the state of play today: James Le Fanu in today’s Telegraph says the BMA, who have recently voted for NHS funding for homeopathy to be withdrawn, aren’t listening to patients but are instead […]
Continue Reading →Medical professionalism in the USA
I’m most impressed at the unabashed and vigorous plea for ‘medical professionalism’ when it comes to doctors and their relationships with pharmaceutical and other commercial companies in the US. It’s in this report, just out, from the Association of American Medical Colleges. It places the need for clear information about potential financial and other biases in […]
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