Category: Health policy

Medicine is not just a science. It is a living practice. Translating emerging science into practice is one of the key skills of doctors. Before scientific knowledge became viral, translation was merely a matter of communication. Now, as the science of medicine reaches epidemic proportions, it is becoming more and more difficult to perform this […]

Medicine is a multinational industry no longer defined by country boundaries. Its main product is a workforce. It is time to disrupt our rigid health care so that it can bend For example, doctors now can work autonomously and remotely from their traditional locations for at least some of their work-time. Radiologists, for example, now […]

Risks are ephemeral. Once identified they are no longer risks but problems to be solved. Risks that cannot or should not be problematized need to be abandoned. In the most positive light, identifying risks should only be a first step in a long pathway of improvement. First, the risk must be linked to a behaviour […]

Under the surface, health care leadership is a stagnant pond filled with ever deepening chasms between the two rival schools – clinicians and managers.  Clinical leadership is no longer about advocating for individual patients, especially about expensive interventions and hospital stays where there is little likelihood of these clinical decisions ever being substantiated by research. […]

Our health care systems are dying under their own weight. They are morbidly obese. They keep on eating up our resources with a voracious appetite. Like clinical obesity, it is not a single problem, but a complex growth that arises from the interaction between our genetic make up, our bodies, our communities and the environment […]

Body organs are a valuable commodity. Nearly every part of the human body has been transplanted – except of course the brain. As the Western world struggles to maintain a charitable stance on organ transplantation which results in long waiting lists, a thriving market in live transplantation exists in many less industrialized countries. Expendable organs, […]

Violence is endemic in our hospitals. In the US, over half of all emergency room staff are threatened by people bearing weapons at least once in their working lives. It is widely reported in the nursing literature, however mentioned much less in the medical literature. Violent thoughts and actions should be expected – they are […]

Governments change. Heads of state change, but what really happens behind the frenzied ADHD of electioneering? The effect on hospitals is very difficult to assess. Paper money and promises abound, but we can never really tell whether decision makers have enough power and status in their hospitals to affect any change during their time on […]

Healthy eating can keep us healthy but what is the health of the foods we eat? Unfortunately, we know very little about the quality of what we ingest. Many of the foods we believe are healthy are not what they say they are. Food fraud, where high value products are replaced by those of lower […]

Proportionate to the numbers, few women manage break to through the glass ceiling in health care and end up having to both lead and manage from below. In the US, whilst almost half of medical school graduates are women, less one in five of these women have positions as full professors and permanent department chairs. […]

Hospitals are full of sick people and not all of them are patients. More and more staff in our hospitals are turning up for work that they are unable to do. They are present, but not working at their best, either due to health problems or other events that are distracting them or both.  It […]

The consequences of the challenge to the Affordable Care Act will extend beyond the US. Whilst woefully inadequate, the Act at least tried to address some of the inequities in health care in the US. On the side lines, countries such as the UK which have national health schemes, have remained silent and self-righteous, resting […]

Most of the biologic waste generated in our homes has the potential to be toxic. The cooked food scraps, fruit and vegetable peels may be organic but that doesn’t mean they are free from harbouring dangerous bacteria. Clostridium perfringes, enterococci and fecal coliforms, Pseudomonas aeruginosa and Staphylococcus aureus are all strains of bacteria which have […]

Health care can‘t keep surviving on unlimited credit cards, even though the role of health funders, both public and private, has shifted from providers to financiers. There needs to be an alternative method for funding our health microenvironment and microservices. The only way for funders to balance their books these days is to restrict services […]

Support medicine based on individuals; not paper. Encourage responsive practice; based on divergent thinking with the ability to converge when necessary. Commit to genuine funding for health, that is, ten percent GDP for ten years from government and private sector. Ensure that hospitals remain places for treating sick people, not making those who treat them […]

Examining bodies is a basic skill for doctors. It is still the first stage in a diagnostic pathway. Nearly every photo we see of doctors has that platinum necklace of physical examination, the stethoscope, swinging from one neck or another. Whilst effective physical diagnosis is universally recognized as essential for good medical practice, there is […]

Health care has a love affair with teams. Everybody wants to be a good team player. Not me. I’m still struggling with the distinction between groups and teams in health care. And I think I want to be a groupie. A lot of health care requires divergent thinking with the ability to converge when we […]

Medicine is a multinational industry no longer defined by country boundaries. Its main product is a workforce. Like the other major product, pharmaceuticals, clinicians are highly regulated and competitively priced. Unlike pharma however, the “product” has not evolved nor are there a succession of new and better models on the market. Postgraduate medical training is […]