BAD SCIENCE (reporting)

New heart attack jab even more effective than statins - Telegraph

Read this story in the Daily Telegraph, a major UK newspaper, and you would be forgiven if you thought that this piece reports a new treatment for patients with coronary artery disease and that this treatment has been compared in a randomised controlled trial with statins and that most of the work was done in Leicester, UK.

STAND UP AND BE COUNTED

I really liked this quick response letter to an anonymously authored piece recently published in the BMJ. The subject is the lack of teaching for junior docs.  I had to reproduce it in full.

Do we have the appetite for a Medical Reformation?
Christoph C Lees, Consultant Obstetrician
NHS University Teaching Hospital, Cambridge
The anonymous author of this piece has hit the nail on the head, but what are we to do?
Rather than pontificate in prose, I'll put down a series of key phrases that most of us will recognise as going some way to redressing the balance: Consultant teaching rounds, on call rotas (as opposed to elaborately constructed shifts), resurrecting the firm structure, team cameraderie, supervision, steep learning curve, rapid acquisition of clinical skills, apprenticeship, renounce EWTD, bedside teaching.
To move towards such a world would require, as happened in the late Middle Ages in Europe (then in a religious context), nothing less than a Reformation. It would require that the Royal Colleges regain their primacy in determining standards and directing postgraduate education; it would require that Doctors renounce their corporate allegiances as de facto civil servants. And it would require the GMC to tear iself from its comfortable position as a Department of health quasi-quango.
Are Doctors willing to stand up and be counted, as the President of the RCS and some other brave souls have recently done-or to push the analogy even further, as Martin Luther did in Wittenberg in 1517? The prize would be an independent profession-and the beneficiary would be our patients.
Competing interests: None declared

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RESURRECTION OF MEDICAL RESEARCH

I apologise for the imagery used during this Holy Week but I felt it was apt.

For a while, I have meant to write something about this article and others on the Wakefield affair which were published in a dedicated BMJ edition earlier this year. 

THE NHS SALAMI SLICER

I am taking a big risk here and I am about to write something in favour of the NHS reforms. Will the British Medical Association ban me from their bosom and send me back my £400 plus? Highly unlikely!

CONFLICT OF INTEREST ITALIAN STYLE

This news article from a recent BMJ is a good example how a conflict of interest between acting in the best interest of a patient and acting in the best interests of 'finances' can end up in the courts. It is not inconceivable that this might happen here in the UK to GPs running consortia. Devolving responsibility downstream also means devolving blame and liability.

SAME OLD SAME OLD

BBC News - Device 'could revolutionise blood pressure monitoring'
Good story but why does it take a foreign startup company to develop the fruits of British research and the investment of British taxpayers? I suspect that British patients treated by a cash strapped NHS will not even benefit from this technology.

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RISING TENSION

This recent article in the New England medical Journal about the future of medical education has caught my eye. The authors quote from another article entitled Cottage Industry to Postindustrial Care — The Revolution in Health Care Delivery' which appeared in an earlier edition of the NEJM - doctors, they state,