This week, a new series starts in The BMJ - the aim is to rethink how hospitals, clinics, community services and public health work - with the aim of stopping the perverse blocks and incentives that prevent doctors, and other healthcare professionals, from providing the care that patients want and need. Talking to Navjoyt Ladher, are Albert Mulley - professor of medicine at the Dartmouth Institute, and Jane Druce, an evaluations manger, and Donal Collins, a GP - both of whom work in an NHS Vangu...
Mar 31, 2017•18 min
Transient symptoms of depersonalisation and derealisation - feeling detached from the world, and feeling as if you are watching events at a remove - are common. However for some, persistent symptoms can make the disorder extremely distressing. In this podcast, Kate Adlington is joined by Elaine Hunter, consultant clinical psychologist, Anthony David, professor of cognitive neuropsychiatry, and by Jane Charlton and Fiona Godlee - who have both experienced depersonalisation/derealisation over a nu...
Mar 31, 2017•32 min
For seven years, Republicans have vowed to repeal the Affordable Healthcare Act (Obamacare), and that promise took a central place in President Trump's campaign. The first major vote to replace it was due to happen last week, but was cancelled at the 11th hour. In advance of the potential vote, The BMJ published a debate asking "Should US doctors mourn for Obamacare?". Now we're asking the authors of that debate, what next? Joining Peter Doshi are Adam Gaffney, from Harvard Medical School and Sa...
Mar 29, 2017•20 min
Lady-Jacqueline Aster lives on a 72 foot canal boat. She's been diagnosed with adrenocortical cancer, and is receiving palliative care and is planning to die in the home she loves. In this interview The BMJ's patient editor, Rosamund Snow, talks to Lady-Jacqueline about her cancer, her care and her funeral plans - and why planning one's own death can be fun. Read more about healthcare on the water http://www.bmj.com/content/356/bmj.j245 Since this recording, Rosamund died by suicide, making thes...
Mar 24, 2017•10 min
The BMJ publishes a lot of educational articles, and in an attempt to help you with your CPD, we have put together this round-up. Our authors and editors will reflect on the key learning points in the articles we discuss, and explain how they may change their practice in light of that new understanding. In this week's round up we're discussing: The offer of an HIV screen for an asymptomatic adult http://www.bmj.com/content/356/bmj.i6656 Two articles on legal highs Novel psychoactive substances: ...
Mar 17, 2017•35 min
Viral exanthema can cause rash in a pregnant woman and should be considered even in countries that have comprehensive vaccination programmes. Measles and rubella can cause intrauterine death. Intrauterine infection with rubella can lead to congenital rubella syndrome in the liveborn baby. In this podcast, Jack Carruthers, honorary clinical research fellow at Imperial College London joins us to discuss spotting a viral rash, what steps to take to assess cause, and what advice to give a worried pa...
Mar 17, 2017•12 min
As the NHS strains under pressure from rising patient activity, an ageing population, and financial constraints, The BMJ hosted a discussion on how clinicians should be helping to manage demand at last week’s Nuffield Trust health policy summit. Taking part are: - Eileen Burns, president of the British Geriatrics Society - Andrew Fernando, GP and medical director of North Hampshire Urgent Care - Candace Imison, director of policy at the Nuffield Trust - Martin Marshall, vice chair of the Royal C...
Mar 16, 2017•53 min
When a person’s heart or breathing stops and the cause is reversible, immediate cardiopulmonary resuscitation (CPR) offers a chance of life. However, when a person is dying—for example, from organ failure, frailty, or advanced cancer—and his or her heart stops as a final part of a dying process, CPR will not prevent death and may do harm. But conversations around that distinction are difficult. In a this podcast, we explore the ways in which these conversations go wrong, and give some practical ...
Mar 08, 2017•34 min
The World Health Organization, the Roll Back Malaria Partnership, and the United Nations, all have a vision of a malaria-free world. The world has already committed to malaria eradication, albeit without a target date. Bruno Moonen, deputy director for malaria at the Bill and Melinda Gates Foundation, thinks that for malaria, eradication is the only equitable and sustainable solution. Where as Clive Shiff, associate professor at the Johns Hopkins Bloomberg School of Public Health, thinks this is...
Mar 07, 2017•15 min
Scott Murray, professor of primary palliative care at the University of Edinburgh, has written, and talked in this podcast before, about the benefits of early palliative care - and today he’s back to explain how illness trajectory, and the pattern of decline at the end of life, affects 4 main areas of wellness - physical, social, psychological and spiritual or existential. Read his full analysis article: http://www.bmj.com/content/356/bmj.j878
Mar 03, 2017•15 min
In 2015, community acquired pneumonia (CAP) accounted for 15% of deaths in children under 5 years old globally and 922 000 deaths globally in children of all ages. In this podcast Iram Haq, a registrar and clinical research associate in paediatric respiratory medicine, joins us to discuss the definition of pneumonia, how to assess for the infection, and what treatments are effective. Read the full clinical update: http://www.bmj.com/content/356/bmj.j686
Mar 02, 2017•11 min
The UK government published its report Childhood Obesity: a Plan for Action, in August 2016. A new analysis article takes them to task for the inadequacy of that response to a growing problem. Neena Modi is a professor of neonatal medicine, at Imperial College London, and president of the Royal College of Paediatrics and Child Health, and joins us to discuss what that report should have contained. Read the full analysis: http://www.bmj.com/content/356/bmj.j762
Mar 02, 2017•14 min
A new rapid recommendation had concluded that LIPUS makes no different to patients experience of bone healing, and therefore shouldn't be used. In this podcast, we talk to three of those panel members - Rudolf Poolman, orthopaedic surgeon from The Netherlands, Stefan Schandelmaier, a methodologist from McMaster University, and Maureen Smith, a patient representative. Read the full recommendation: http://www.bmj.com/content/356/bmj.j576
Feb 24, 2017•18 min
All doctors, irrespective of their specialty or the setting in which they work, will care for patients who die. Around half of all deaths occur in hospitals. Evidence suggests that the quality of communication around this process is poorer in hospitals than in other settings, according to responses from relatives who have experienced bereavement. Over half of NHS complaints concern care of the dying. In this podcast, Katherine Sleeman, clinician scientist and honorary consultant in palliative me...
Feb 21, 2017•23 min
Persistent physical symptoms are common and include those symptoms that last at least three months and are insufficiently explained by a medical condition after adequate examination and investigation. Observational studies in primary care report that women, especially those aged 35-45 years, more commonly present with these symptoms. In this podcast, Madelon den Boeft, a GP and, Nikki Claassen-van Dessel, a GP trainee, both in The Netherlands, join us to explain why listening to a patient is imp...
Feb 17, 2017•14 min
Vivek Murthy, the US surgeon general, has highlighted prescription opioid misuse as a serious public health problem. In this podcast, Richard Hurley speaks to him about what he thinks needs to be done to tackle the issue. http://www.bmj.com/content/356/bmj.j715
Feb 15, 2017•32 min
Evidence shows using electronic health records can increase efficiency, and reduce preventable medical errors - but only if they are used properly. However, in the US, the president of the American Medical Association calls them almost unusable. In this debate, Richard Hurley is joined by George Gellert, Regional Medical Informatics Officer at CHRISTUS Santa Rosa Health System and Edward Melnick, Assistant Professor of Emergency Medicine at Yale, who debate whether US doctors should be using ele...
Jan 19, 2017•13 min
The use of novel psychoactive substances is increasing, however there is little information about what these are, and how they work. Dr Derek Tracy, consultant psychiatrist at Oxleas NHS Foundation Trust, and David Wood, consultant physician and toxicologist at Guy's and St Thomas' NHS Foundation Trust join us to explain that doctors already know how to deal with these, if they think about them in terms of traditional drug use. Read the two related articles: http://www.bmj.com/content/356/bmj.i6...
Jan 19, 2017•25 min
http://evidencelive.org/manifesto/ The BMJ, and the Centre for Evidence Based Medicine in Oxford have long collaborated to document the problems with the creation and use of Evidence based medicine - and together we host evidence gatherers, synthesisers and users in the conference Evidence Live. We know what the problems are - but what would positive change, when it comes to the creation and use of medical evidence look like? To find out we’re doing a series of discussions at various places arou...
Jan 19, 2017•18 min
Should gluten-free foods be available on prescription? A gluten free diet is the main treatment for celiac disease, and gluten-free food has been available on prescription from the NHS. However, as finances become tighter, in some areas patients no longer have that option. Prescriptions of gluten free food is the same as a prescription for a drug, argues David Sanders, professor of gastroenterology from Royal Hallamshire Hospital, but James Cave lambasts a costly system that frustrates patients ...
Jan 13, 2017•19 min
Surrogate endpoints are commonly used in clinical trials to get quicker results, however Michael Baum, emeritus professor at University College London, worries that by not focusing on real outcomes - length of life, and quality of life - that these are being used to justify expensive treatments which may not benefit patients. Read the full analysis: http://www.bmj.com/content/355/bmj.i6286
Jan 06, 2017•14 min
State regulation is necessary for safety, says Simon Capewell, professor of public health and policy at the University of Liverpool. Richard Lilford, professor of public health at the University of Warwick, argues that restricting adults’ choice can undermine such aims. Read the debate: http://www.bmj.com/content/355/bmj.i6341
Jan 03, 2017•15 min
In this year's Christmas BMJ 2016 podcasts, we’ve been discussing morality, compassion, truth. In this final one, it's time for war. After the second world war, there was an attempt to bring a moral sense to conflict - and Julian Sheather, specialist adviser on ethics and human rights to the BMA, and author of the christmas editorial “medicine under fire” is worried about the retrenchment of those ideals. http://www.bmj.com/content/355/bmj.i6464 Peter Wever is a doctor in The Netherlands, and ha...
Dec 23, 2016•27 min
In response to the turmoil of 2016, with political campaigns being run on, and won on, misinformation - many commentators are disparing that we’ve become a post-truth society. And what is truth anyway? Tracy Brown, director of Sense about Science, the charity set up to champion evidence in everyday life, is less pessimistic about the public's appetite for evidence. http://www.bmj.com/content/355/bmj.i6467 Anders Huitfeldt, a postdoctoral scholar at Stanford University School of Medicine, and has...
Dec 22, 2016•27 min
Underneath all of our civilisation and science, we’re still primates - and the connection between patient and doctor can be reinforced by simply taking a hand. Robin Youngson, cofounder of hearts in healthcare, and Mitzi Blennerhassett, who has written extensively on patient engagement, have co-authored an editorial calling for the humanisation of medicine, and we talk to them about the power of touch. Read the editorial: www.bmj.com/content/355/bmj.i6262 Andrew Steptoe is the British Heart Foun...
Dec 21, 2016•24 min
In an ideal world, policies would be evidence based - but governments are made of humans, who have positions and ideologies and moral bases. In this podcast Anthony Painter, from the RSA will be talking about why universal basic income may work, but who’s proponents cross ideological barriers, and writer and philosopher AC Grayling explains how economic arguments become moral crusades. A universal basic income: the answer to poverty, insecurity, and health inequality? http://www.bmj.com/content/...
Dec 16, 2016•33 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 new monthly audio round-up The BMJ’s clinical editors discuss what they have learned, and how they may alter their practice. In our second audio edition, GPs Sophie Cook and Helen Macdonald, surgical trainee Jessamy Baganel, and internalist and methodologist Reed Siemieniuk, talk about the evidence for...
Dec 07, 2016•36 min
Renal transplantation improves quantity and quality of life compared with chronic dialysis. A UK general practice with 8000 patients will have around four patients with a functioning renal transplant, one patient on the transplant waiting list, and several under consideration for transplantation. Many medical problems in renal transplant recipients will be managed by non-specialist clinicians, and this article provides advice for the non-specialist on managing renal transplant patients. In this ...
Dec 02, 2016•31 min
Glasgow GP, writer, broadcaster, and The BMJ's weekly columnist Margaret McCartney joins us to talk about her new book "The State of Medicine: Keeping the Promise of the NHS". Read all of Margaret's columns: goo.gl/iKmmie
Nov 28, 2016•22 min
Despite high quality systematic reviews reporting ineffectiveness, many guideline groups continue to recommend vitamin D supplementation (with or without calcium) for fall or fracture prevention. Recently Public Health England recommended that everyone needs vitamin D equivalent to an average daily intake of 10 μg (400 IU) to protect bone and muscle health, In this podcast, Andrew Grey, associate professor of medicine at the University of Aukland joins us to discuss what the evidence says for wh...
Nov 25, 2016•13 min
