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 […]
Category: Health policy
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 […]
I’ve just participated in a public debate: “This house believes that Brexit will not affect health innovation”. I was on the opposing site. Have you ever been in a debate where if you win you lose? That’s where I found myself. Because if we won, the future is bleak. And if we lost, the future […]
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 […]
I n this era of personalized medicine there is nothing general anymore. So why do we persist with terms so wholly inappropriate to the kind of care delivered in the community by doctors? “Family medicine” as a term has the scope to address the newer genetic aspects of our work but still misses out on […]
It’s hard for leaders to breathe life into health care these days because the atmosphere is so polluted by frequent restructuring. Clinical leaders and their teams lose the commitment that made them choose to work in health care in the first place. Teams are worn down by continual change without seeing any positive benefit. Leaders […]
Having more than one health problem is more common than we think and potentially deadly. Almost one in every four of us has two or more health conditions. With each additional disease morbidity, mortality and polypharmacy increases. Some think multimorbidity can be cured by focusing on the whole patient. Research shows the opposite. Multiple health […]
Just as dinosaurs became too big to roam the earth the demand for quality in health care has spawned enormous and unfathomable datasets that have outgrown their usefulness. I can live with that if I know that the reams of raw data are being used to underpin realistic, reliable, decisions. But they’re not. Right now […]
New evidence suggests that taking a combined cocktail of preventive medications can help us live longer. In these times of soaring health expenditure this should be good news to public health. But governments seem reticent to invest in combined preparations even when they can potentially extend life, minimize morbidity and deliver cheap pharmaceuticals. The problem […]
Between cure and death a lot occurs. It has a name: plateauing. And in treatment it means: do nothing and for some diseases it’s the perfect therapy. Take the Zika outbreak. We now know that patients with Zika and accompanying paralysis, Guillain-Barre syndrome, seem to go through a plateau phase (three to 10 days). The […]
Even today with broad access to good online information and a wealth of evidence about the myriad ways that disruptive technologies provide access to services, most of us still leave healthcare choices to trusted advisors – usually our doctors. What we don’t realize is that this behaviour is exactly what governments and private health insurers […]
The battle against obesity is as relentless as the fight against sugar. The difference is that the fight against sugar is one of global economics rather than public health. And that’s a problem based in the history of research. Obesity first emerged as the blockade against bad fats in our diet and quickly became confused […]
Well, not exactly but disease should be dead and treatment should be reigning. In the 21st century, as we delve into the minutiae the body, the smaller we can see, the more we describe and define. But by using old methods of disease description we continue to differentiate rather than unify concepts and this results […]
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