Category: Healthcare

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 […]

The end of the summer holidays always signals a spate of new television and internet dramas. Medical dramas, in particular, are very cost effective for the television and streaming industries. Sets are simple. There are stock storylines that can be regularly recycled, such as cancer, rape, accidental injury, and paralysis. Usually there is only one […]

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 […]

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 […]

In these troubled times, we all like to hear good news and health care is one area that seems to abound with uplifting language. Daily posts about “cures” and “new treatments” raise our spirits and are antidotes to the bleak predictions about shrinking health services and budgets. Even “groundbreaking”, which usually refers to some treatment […]

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 […]

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 […]

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 […]

Being an olympian is a dangerous occupation. In the sixteen days of competition one in ten athletes will sustain an injury during the games. Of these injuries one in three will prevent the athlete from competing or continuing to compete. During the games we only hear of the spectacular injuries and so far in Rio, […]

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 […]

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 […]