Wendy Burn is a consultant old age psychiatrist, and new president of the Royal College of Psychiatrists. Her work on dementia has given her an affinity for the neurobiological basis of psychiatry - and her tenure at the college is seeing a move to wards this neurobiological model in the teaching of the profession. In this interview she talks about her work, how the profession is changing, and why she thinks Kanye can be a model for mental health.
Jun 29, 2018•27 min
Ray Moynihan is a senior research assistant at Bond University, a journalist, champion of rolling back too much medicine, and host of a new series “The Recommended Dose” from Cochrane Australia. In the series, Ray has talked to some of the people who shape the medical evidence that underpin healthcare around the world - the series aim is to elucidating their worldview, and how their thinking shapes their work. Over the next couple of months, we’ll be co-publishing the series - so keep an ear out...
Jun 28, 2018•16 min
At evidence live this year, one of the sessions was about the work of Evidence Aid - and their attempt to bring high quality evidence to the frontline of a humanitarian crisis. In that situation, it’s very difficult to know what will work - a conflict, or even immediately post-conflict situation is characterised by chaos - and merely doing something is vital. But though each situation is unique, sharing what’s worked elsewhere can be key to maximising the help given to vulnerable people....
Jun 25, 2018•29 min
At Evidence Live this year, the focus of the conference was on communication of evidence - both academically, and to the public. And part of that is the role that investigative journalism has to play in that. At the BMJ we’ve used investigative journalistic techniques to try and expose wrong doing on the part of government and industry - always in collaboration with clinicians and researchers. To explain a bit more about the world of journalism and campaigning, we're joined by to Shelley Jofre -...
Jun 22, 2018•32 min
Don Berwick, president emeritus of the Institute of Healthcare Improvement, and former Administrator of the Centers for Medicare and Medicaid Services. In this conversation he discusses how he went from being a paediatrician to running Medicare for Obama, how we can create headroom in stressed systems, and breaking the rules to make things better for patients and staff. Quality improvement series:
Jun 15, 2018•27 min
When tackling societal problems - like the opioid epidemic in the US - there are two ways of approaching it. One is to reduce demand - by organising treatment programmes, or reducing the underlying reasons why people may become addicted in the first place - but that’s hard. So governments often turn to the other route - reducing supply - and that’s what the US government did in 2014 when it rescheduled oxycodone combination products from schedule 3 to schedual 2 - essentially making it harder fo...
Jun 15, 2018•29 min
Series two of The Recommended Dose kicks off with polymath and poet, Dr John Ioannidis. Recognised by The Atlantic as one the most influential scientists alive today, he’s a global authority on genetics, medical research and the nature of scientific inquiry itself – among many other things. A professor at Stanford University, John has authored close to 1,000 academic papers and served on the editorial boards of 30 of the world's top journals. He is best known for seriously challenging the status...
Jun 15, 2018•1 hr 2 min
There’s a lot going on in the world at the moment - Ebola’s back, Puerto Rico is without power and the official estimations of death following the hurricane are being challenged. The WHO’s just met to decide what to do about it all, as well as sorting out universal healthcare, access to medicines, eradicating polio, etc etc. To make sense of that a little, we grabbed Ashish Jha - Director of the Harvard Global Health Institute to shed some light into how decisions about global health are made, a...
Jun 08, 2018•48 min
We at The BMJ care about food, and if our listener stats are to be believed, so do you. In this podcast we talk to a few of the authors of a new series, published next week on bmj.com, which tries to provide some insight into the current state of nutritional science - where the controversies lie, where there’s broad agreement, and the journey of our understanding of nutrition. The open access fees for those articles has been paid for by Swiss Re - a wholesale provider of reinsurance, insurance a...
Jun 08, 2018•52 min
In December 2017, the NEJM’s national corespondent, Lisa Rosenbaum, published an article “The Less-Is-More Crusade — Are We Overmedicalizing or Oversimplifying?” The article aimed a broadside against those who are campaigning against the overuse of medicine, and the over diagnosis of treatment. This week in the BMJ we’ve published a rebuttal to that article, and in this podcast we talk to Steve Woloshin and Lisa Schwartz - both professors at the Dartmouth Institute for Health Policy and Clinical...
May 31, 2018•28 min
Each time you order a test for a child, do you think the population that makes up the baseline against which the results are measured? It turns out that that historically those reference intervals have been based on adults - but children, especially neonates and adolescents, are undergoing physiological changes that mean those reference intervals may not be appropriate. To get around this Khosrow Adeli, head and professor of clinical biochemistry at the Hospital for Sick Children, and the Univer...
May 25, 2018•23 min
Patients who are depressed and prescribed antidepressants may report weight gain, but there has been limited research into the association between the two. However new observational research published on bmj.com aims to identify that association. Rafael Gafoor, a psychiatrist and researcher at Kings College London, and one of the authors of that research joins us to talk about the potential mechanism of action - is it a physiological response to the drug, is it to do with the underlying reason f...
May 25, 2018•17 min
Complexity science offers ways to change our collective mindset about healthcare systems, enabling us to improve performance that is otherwise stagnant, argues Jeffrey Braithwaite, professor of health systems research and president elect of the International Society for Quality in Health Care. Read the full analysis: https://www.bmj.com/content/361/bmj.k2014 Quality improvement series: https://www.bmj.com/quality-improvement The BMJ in partnership with and funded by The Health Foundation are lau...
May 19, 2018•37 min
There’s been a lot of attention given to the new antirviral drugs which target Hepatitis C - partly because of the burden of infection of the disease, and the lack of a treatment that can be made easily accessible to around the world, and partly because of the incredible cost of a course of treatment. But a new article on BMJ talks about the uncertainly of that treatment - do we know that the drugs actually clear a HepC infection, and that this will lead to a corresponding decrease in mortality ...
May 12, 2018•17 min
Worldwide, the rate of type II diabetes is estimated to be around 1 in 11 people - about 9%. For the Pima people of Arizona, 38% of the adult population have the condition - but across the border in Mexico, the rate drops down to 7%. The difference between the groups is their life experience - one side displaced, the other on their traditional lands - and their experience is being replicated elsewhere. Lauren Carruth, assistant professor at The American University, joins us to talk about the Pim...
May 08, 2018•23 min
We’re in an era of big data - and hospitals and GPs are generating an inordinate amount of it that has potential to improve everyone’s health. But only if it’s used properly. New research published on www.bmj.com this week describes another set of information, about that data, that the authors believe could be just as important as the data itself. Griffin weber, and Isaac Kohane, from the Department of Biomedical informatics at Harvard medical school join us to discuss. Read the full research: h...
May 04, 2018•20 min
The array of options available to pharmaceutical companies, to advertise their drugs, is incredibly broad - and the amount that they spend is increasing, with some reports saying it’s up 60% in the last five years. In most countries, there are pretty strict rules to limit the ways in which Pharma can spend their advertising dollars - but the WHO guidelines which have informed many of those rules are now 30 years out of date. A new analysis on bmj.com “Ethical drug marketing criteria for the 21st...
May 03, 2018•26 min
For many people, cancer is now survivable and has become a long term condition, and depression and anxiety are more common in cancer survivors than in the general population. Despite this, 73% of patients don't receive effective psychiatric treatment. Alexandra Pitman, consultant liaison psychiatrist at St George’s University Hospitals NHS Foundation Trust, and Andrew Hodgkiss, consultant liaison psychiatrist, at the Institute of Psychiatry, Psychology & Neuroscience join us to dispel some of th...
Apr 26, 2018•38 min
Smokers want to vape, it can help them quit, and it’s less harmful than smoking, say Paul Aveyard professor of behavioural medicine at the University of Oxford. But Kenneth C Johnson, adjunct professor at the University of Ottawa, argues that smokers who vape are generally less likely to quit and is concerned about youth vaping as a gateway to smoking, dual use, and potential harms from long term use. Read the debate: https://www.bmj.com/content/361/bmj.k1759
Apr 23, 2018•33 min
Harry Burns was a surgeon, who gave up his career in that discipline to become a public health doctor. Eventually that lead to him being the last Chief Medical Officer of Scotland, and now he’s professor of global public health at the University of Strathclyde. Scotland has always had a separate NHS, but since devolution, the parliament there has had much more autonomy in running the country - and Harry has seemed to manage to convince them that improving health means improving the social determ...
Apr 20, 2018•43 min
We talk about financial conflicts of interest a lot atThe BMJ - and have take taken the decision that our educational content should be without them. We also talk a lot about non-financial conflicts of interest, but the choppy waters of those are much more difficult to navigate. In this podcast, we discuss whether we should, or if we could even could, make people’s intellectual positions transparent. Arguing that it’s important to tackle this issue, are Wendy Lipworth and Ian Kerridge from Sydne...
Apr 13, 2018•35 min
In 2016, from an estimated pre-war population of 22 million, the United Nations (UN) identified 13.5 million Syrians requiring humanitarian assistance, of which more than 6 million are internally displaced within Syria, and around 5 million are refugees outside of Syria. In this podcast, Aula Abarra, consultant in infectious disease from London, joins us to discuss what's happening now in Eastern Ghouta, and area of Damascus, where civilians are being held under siege, where humanitarian aid is ...
Apr 03, 2018•15 min
The first digital banking in the UK was launched in 1983, Skype turns 15 this year, but 2017 finally saw panic over the impact that online consultations may have on general practices. In this podcast Martin Marshall, professor of healthcare improvement at University College London joins us to discuss whether video conference actually is a disruptor, or whether it’s actually the whole business model of general practice that needs to change. Read the full analysis: https://www.bmj.com/content/360/...
Mar 28, 2018•21 min
When a new drug reaches market, the race is on to find more indications for its use - exploratory trials are set up, and positive results can lead to the off label prescriptions (eg Pregabalin for lower back pain. However, these initial indications are rarely confirmed with further, better quality, evidence. Jonathan Kimmelman is an associate professor at MCgill University in Canada, thinks it's time to explore less, and confirm more - and joins us to explain why. Read the full analysis: http://...
Mar 23, 2018•24 min
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
