Ravi Gupta, is a resident in internal medicine at Johns Hopkins in Baltimore - and as he said has seen the influence of sudden price hikes on his patients - between 2010 and 2015 more than 300 drugs in the U.S. have seen sudden increases of over %100. Ravi and his co-authors have suggested, and tested the feasibility of, a possible answer to those price hikes - a small tweak that should protect patients from the possibility that they’ll suddenly be unable to afford their essential medication. Re...
Mar 23, 2018•19 min
”An additional person died every seven minutes during the first 49 days of 2018 compared with what had been usual in the previous five years. Why? In this podcast, Danny Dorling, Halford Mackinder professor of geography at the university of Oxford, talks about the spike in mortality, what that means for overall life expectancy in the UK (spoiler, it’s not great) and what he thinks could be fuelling the change. Read the full editorial http://www.bmj.com/content/360/bmj.k1090 For more information,...
Mar 16, 2018•20 min
That’s Jo Shapiro is a surgeon and manager in Brigham and Women’s hospital, she’s also director of the Center for Professionalism and Peer Support, and has written an editorial for The BMJ on tackling unprofessional behaviour. In this discussion, she and I talked about what she thinks (beyond the illegal) are the most damaging behaviours seen around a hospital, what needs to be done to set up an environment that allows the victims of unprofessional behaviour to speak out about senior members of ...
Mar 12, 2018•48 min
Our latest debate asks, should doctors recommend acupuncture for pain? Asbjørn Hróbjartsson from the Center for Evidence-based Medicine at University of Southern Denmark argues no - evidence show's it's no worse than placebo. Mike Cummings, medical director of the British Medical Acupuncture Society argues yes - that there is evidence of efficacy, and trials haven't been designed to accurately measure that. We also hear from Kumari Manickasamy, a GP in north London, and someone who used acupunct...
Mar 08, 2018•27 min
In this year's Nuffield Summit round table we're asking, how can the NHS become a good employer? At the moment, there is a recruitment and retention crisis across the workforce, doctors and nurses are leaving the NHS in droves, rota gaps are prevalent. A recent BMA survey showed that the majority of junior doctors are now planning to take a career break. So against this backdrop, what can the NHS do to nurture it's employees, and make medicine an exciting proposition for the millennial, and subs...
Mar 07, 2018•43 min
Its now widely agreed that one of the key ways of reducing the current high level of "waste " in biomedical research is to focus it more squarely on addressing the questions that matter to patients - and the people and medical staff that care for them. In this interview, Tessa Richards - the BMJ's patient partnership editor, talks to Katherine Cowan, independent consultant and a senior advisor the the James Lind Alliance, which has pioneered patient involvement with their research priority setti...
Mar 02, 2018•28 min
Up to $500m a year could be put to better use by stopping ineffective and potentially harmful supplementation programmes in poorer countries, argues John Mason, professor emeritus at Tulane University School of Public Health and Tropical Medicine. However Keith West, professor of infant and child nutrition at Johns Hopkins Bloomberg School of Public Health disagrees, saying that such programmes have been proved to save millions of lives and should be withdrawn only when robust evidence permits. ...
Mar 01, 2018•18 min
International travel is increasingly common. Between 10% and 42% of travellers to any destination, and 15%-70% of travellers to tropical settings experience ill health, either while abroad or on returning home, Malaria is the commonest specific diagnosis, accounting for 5%-29% of all individuals presenting to specialist clinic, followed by dengue, enteric fever, and rickettsial infections . In this podcast Doug Fink specialist registrar, and Victoria Johnston consultant, in infectious diseases a...
Feb 20, 2018•32 min
In a new analysis John McArthur and Krista Rasmussen, from the Global Economy and Development Program at the Brookings Institution, and Gavin Yamey from Duke University, have set out to analyse the potential for lives saved by the goals set in the Sustainable Development Goals In this conversation I talked to Gavin and John about the numbers, which countries have to accelerate their development to meet those goals - and we also address some of the criticisms of the SDGs - that they’re too wide r...
Feb 17, 2018•44 min
A study published by The BMJ today reports a possible association between intake of highly processed (“ultra-processed”) food in the diet and cancer. Ultra-processed foods include packaged baked goods and snacks, fizzy drinks, sugary cereals, ready meals and reconstituted meat products - often containing high levels of sugar, fat, and salt, but lacking in vitamins and fibre. They are thought to account for up to 50% of total daily energy intake in several developed countries. Mathilde Touvier, s...
Feb 15, 2018•22 min
Sabine Netters is an oncologist in The Netherlands - where assisted dying is legal. There doctors actually administer the drugs to help their patients die (unlike proposed legislation in the UK). In this moving interview, Sabine explains what was going through her head, the first time she helped her patient die - and how in the subsequent years, the emotional toll hasn't lessened. She explains why she believes that in certain circumstances, euthanasia can be the ultimate caring act. Read her ess...
Feb 08, 2018•27 min
Bobbie Farsides is professor of clinical and biomedical ethics at Brighton and Sussex Medical School. She’s been described as one of the few people that is acceptable to “both sides” of the assisted dying debate. This week she joins us to talk about the way in which the debate on euthanasia has played out in the UK - and hear why she thinks it’s now time for all individual doctors to make up their own mind, and not let either camp own the argument for them. Read her commentary on the debate: htt...
Feb 08, 2018•21 min
The UN Convention against Torture defines torture as “any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person” by someone acting in an official capacity for purposes such as obtaining a confession or punishing or intimidating that person. It is unethical for healthcare professionals to participate in torture, including any use of medical knowledge or skill to facilitate torture or allow it to continue, or to be present during torture. Yet med...
Feb 05, 2018•18 min
The number of people officially recorded as sleeping on the streets of England rose from 1768 in 2010 to 4751 in autumn 2017.1 Charities estimate the true figure to be more than double this. Danny Dorling, Halford Mackinder professor of geography at the University of Oxford joins us to explain what's fuelling that rise, why the true extent of the problem is far larger, and what steps need to be taken to tackle the epidemic. Read the editorial: http://www.bmj.com/content/360/bmj.k214
Feb 02, 2018•17 min
We have evidence on which to act, and inaction costs lives, argues Simon Capewell, Professor of Public Health and Policy, at the University of Liverpool. But Aileen Clarke, professor of public health and health services research at Warwick Medical School, says our understanding of the human behaviour that leads to unhealthy choices is still lacking Read the head to head http://www.bmj.com/content/360/bmj.k292
Feb 01, 2018•22 min
We know that smoking 20 cigarettes a day increases your risk of CHD and stroke - but what happens if you cut down to 1, do you have 1/20th of that risk? Allan Hackshaw, professor of epidemiology at UCL joins us to discuss a new systematic review and meta analysis published on bmj.com, examining the risk of smoking just one or two cigarettes a day. Read the full review: http://www.bmj.com/content/360/bmj.j5855
Jan 25, 2018•14 min
Virginia Murray, public health consultant in global disaster risk reduction at Public Health England, was instrumental in putting together the Sendai Framework for Disaster Risk Reduction - an international agreement which aims to move the world from reacting to disasters, to proactively preventing them. In this podcast, she explains what they learned in the process, and why science had to become storytelling, in order to make politicians pay attention. Read the editorial on creating a set of in...
Jan 24, 2018•25 min
The BMJ publishes a variety of education articles, to help doctors improve their practice. Often authors join us in our podcast to give tips on putting their recommendations into practice. In this audio round-up The BMJ’s clinical editors discuss what they have learned, and how they may alter their practice. Kate Addlington, associate editor and trainee psychiatrist is joined by Cat Chatfield, quality editor and GP. They discuss acute respiratory distress syndrome: http://www.bmj.com/content/359...
Jan 22, 2018•39 min
Many older adults have difficulty understanding speech in acute healthcare settings owing to hearing loss, but the effect on patient care is often overlooked. Jan Blustein professor of health policy and medicine at New York University, and who has also experienced the affects of hearing loss, joins us to explain what that's like, and gives some tips on making it easier to communicate. Read the full analysis: http://www.bmj.com/content/360/bmj.k21 Full transcript of the interview: https://docs.go...
Jan 19, 2018•16 min
Trial MVA85A - monkey trials for a booster vaccine for BCG, developed by researchers at Oxford University, is the subject of an investigation published on bmj.com. Experts warn that today’s investigation is just one example of “a systematic failure” afflicting preclinical research and call for urgent action “to make animal research more fit for purpose as a valuable and reliable forerunner to clinical research in humans.” The press conference is led by Dr Fiona Godlee, the editor-in-chief of the...
Jan 11, 2018•49 min
Neoadjuvant chemotherapy for breast cancer is a new strategy that was introduced towards the end of the 20th century with the aim of reducing tumour size - rendering an otherwise inoperable tumour operable, allowing more conservative surgery, and hopefully improving overall survival. Although data indicate that the first rationale remains valid, the others have not led to the desired outcomes. More conservative surgery after neoadjuvant chemotherapy can result in a higher rate of local recurrenc...
Jan 11, 2018•19 min
Winter pressures on NHS services have kicked in a little bit earlier than usual. So here to discuss that, and also the issue of how local NHS leaders can support staff in times of extreme pressure. Discussing that with Rebecca Coombes, The BMJ’s head of news and views, are Matthew Inada-Kim, a consultant in acute and general medicine at Hampshire Hospitals NHS Foundation Trust, and Joe Harrison, CEO of Milton Keynes Hospital NHS Foundation Trust.
Jan 10, 2018•39 min
Acute respiratory distress syndrome was first described in 1967 and has become a defining condition in critical care. Around 40% of patients with ARDS will die, and survivors experience long term sequelae. No drug treatments exist for ARDS, however good supportive management reduces harm and improves outcome. In this podcast, John Laffey, professor of anaesthesiology at St Michael’s Hospital, Toronto and Brian Kavanagh, clinician-scientist, intensive care medicine at the University of Toronto ta...
Jan 03, 2018•44 min
Psychosis often emerges for the first time in adolescence and young adulthood. In around four out of five patients symptoms remit, but most experience relapses and further difficulties. Psychosis can be a frightening and bewildering experience for both patients and families. Early proactive support and intervention improves clinical outcomes, avoids costly and traumatic hospital admissions, and is preferred by patients and their families In this podcast,Sagnik Bhattacharyya, consultant psychiatr...
Dec 31, 2017•42 min
The notion that animal companionship might be linked to human health can be traced to ancient writings and, with the first population based study conducted at least four decades ago. Although some empirical evidence links animal companionship with apparent protection against a series of important health outcomes in middle aged populations, including premature mortality, obesity, hypertension, and hyperlipidaemia, systematic reviews and position statements suggest that these associations are not ...
Dec 15, 2017•21 min
Wine glasses come in a range of sizes, but the average wine glass in the UK today can hold almost ½ a litre. That wasn’t always the case - and a new analysis, on bmj.com takes a look at the changing size of wineglasses from 1700 until now. To discuss how the size of glass affects consumption we're joined by Theresa Marteau, director of the Behaviour and Health Research Unit at the University of Cambridge and Zorana Zupan, a research associate in the Unit. We're also joined by Matthew Winterbotto...
Dec 14, 2017•33 min
Average body temperature is 37°C, right? That was the conclusion of Carl Wunderlich in his magnum opus, The Course of Temperature in Diseases - Wunderlich published that in 1868, following his extensive collection of body temperature readings - and 37°C stuck. But, it’s not as simple as that Philip Mackowiak, emeritus professor of medicine, and now history of medicine scholar in residence, at the University of Maryland School of Medicine, has been interested in temperature for a long time. He jo...
Dec 13, 2017•25 min
Manflu, the phenomenon that men experience the symptoms of viral illness more than woman, is usually used with derision - but a new review, published in the Christmas edition, is asking - is there a plausible biological basis for this sex difference? Kyle Sue is a clinical assistant professor in family medicine at Memorial University of Newfoundland, and a GP in northern Canada - and has been looking at the research on sex difference in immune response. Read the full article: http://www.bmj.com/...
Dec 12, 2017•21 min
Assessing young people with possible eating disorders can be complex for a variety of reasons. Building a therapeutic relationship with a young person with a possible eating disorder and their family is key to enabling a thorough assessment and ongoing management, but it introduces difficult issues regarding confidentiality and risk. In this podcast we speak to the mother and daughter authors of a What you patient is thinking article, who describe what it's like for a family to experience a chil...
Dec 10, 2017•43 min
Assessing young people with possible eating disorders can be complex for a variety of reasons. Building a therapeutic relationship with a young person with a possible eating disorder and their family is key to enabling a thorough assessment and ongoing management, but it introduces difficult issues regarding confidentiality and risk. In this podcast we talk with the authors of two practice articles, which give advice on spotting and treating eating disorders in young people. In a linked podcast,...
Dec 10, 2017•43 min
