Episodes

  • In our new season of Doctor Important, we'll be discussing topics that are not always talked about, and today, by popular request of our listners, we're talking about Coroner's Court and inquests - two things that strike terror into doctors, but are often not as bad as you may fear.Our panel;Clara Munro is a surgical trainee in the North East Deanery.She's joined by her colleage Katie Strong, another surgical trainee. We also have returning to Doctor Informed Ayisha Ashmore, an Obs and Gynae registrar in the East Midlands.

    Our Expert guest this week is Beth Walker, a former palliative care registrar who now works as an advisor for Medical Protection.

  • This is our last episode of series 1 of Doctor Informed, and with it we're coming full circle. Clara will be talking to our first two guests, Mary Dixon-Woods and Bill Kirkup, having now heard from all of our other experts over this series. In this first series, we've learned about speaking out, team work, compassionate leadership - all the things that are needed to help clinicians challenge the status quo, So in this episode, we'll be asking Mary how much she thinks things have changed, and Bill how he manages a career challenging the healthcare system.Our guestsMary Dixon-Woods is director of THIS Institute, and a Health Foundation Professor of Healthcare Improvement Studies in the Department of Public Health and Primary Care at the University of Cambridge. Her work is concerned with generating a high quality evidence-base to support the organisation, quality and safety of care delivered to patients.For links to the work that Mary talked about visit https://www.thisinstitute.cam.ac.uk/

    Bill Kirkup is a clinician turned investigator - he led investigations into failings at a maternity and neonatal unit in Morcambe Bay, into the Oxford paediatric cardiac surgery unit and into Jimmy Savile’s involvement with Broadmoor Hospital. He was also a member of the Hillsborough Independent Panel

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  • In this week's episode, Joe Ross, professor of medicine at Yale, and The BMJ's US research editor, and Juan Franco, researcher at Heinrich-Heine-Universität and editor in chief of BMJ EBM are in the hot-seat.They will discuss new research on the effectiveness of antidepressants - based on all the individual patient data submitted to the FDA between 1979 and now. We'll take a look at a study of industry sponsorship of cost effectiveness analysis, and seeing similar patters of publication bias to RCTs.And finally we'll be talking about new research on the ongoing, and emergent pandemics - covid and monkeypox.Reading listResponse to acute monotherapy for major depressive disorder in randomized, placebo controlled trials submitted to the US Food and Drug Administration: individual participant data analysishttps://www.bmj.com/content/378/bmj-2021-067606) Using individual participant data to improve network meta-analysis projectshttps://ebm.bmj.com/content/early/2022/08/10/bmjebm-2022-111931 Industry sponsorship bias in cost effectiveness analysis: registry based analysishttps://www.bmj.com/content/377/bmj-2021-069573 Clinical features and novel presentations of human monkeypox in a central London centre during the 2022 outbreak https://www.bmj.com/content/378/bmj-2022-072410 Effectiveness of a fourth dose of covid-19 mRNA vaccine against the omicron variant among long term care residents in Ontario, Canada:

    https://www.bmj.com/content/378/bmj-2022-071502

  • Previous Doctor Informed episodes have discussed how to prevent patient safety issues from occurring, but sometimes situations are beyond anyone's control - like COVID.It can be hard to look back, especially if difficult decisions and compromises were made, including ones we did not completely agree with, or if there could be criticism of the way we responded. We ask how individual doctors, teams, and organisations could respond to and recover from major problems?In this episode, we're joined by Annelieke Driessen, a THIS Institute fellow and medical anthropologist. She is a research fellow at the University of Oxford and honorary assistant professor in medical anthropology at the London School of Hygiene and Tropical Medicine, who has spent hours listening to and understanding patient experiences of ICU during the pandemic. We'll also hear from Dominque Allwood, Chief Medical Officer at UCL Partners, and Director of Population Health at Imperial College Healthcare NHS Trust, who focuses on creating positive change in healthcare.

    The research Annelieke Driessen discussed, and the full versions of the patient interviews that are included in the podcast are available at https://healthtalk.org/Experiences-of-Covid-19-and-Intensive-Care/overview

  • In this episode, Juan Franco, editor in chief of BMJ EBM, and Helen Macdonald, The BMJ's research integrity editor, sit down to discuss what's new in the world of evidence.Firstly, last week they went to the first EBM Live conference for two years - and report back on what happened when the evidence community got back together.We have two research papers looking at knees and shoulders, and finding out about the balance of risks and benefits.In covid news, we're still finding new symptoms associated with infection, 2.5 years after the pandemic started. We'll also hear how complex it is to research vaccine efficacy now.Reading list:Smell and taste dysfunction after covid-19 https://www.bmj.com/content/378/bmj.o1653Serious adverse event rates and reoperation after arthroscopic shoulder surgeryhttps://www.bmj.com/content/378/bmj-2021-069901Viscosupplementation for knee osteoarthritishttps://www.bmj.com/content/378/bmj-2022-069722Waning effectiveness of BNT162b2 and ChAdOx1 covid-19 vaccines over six months since second dose

    https://www.bmj.com/content/378/bmj-2022-071249

  • As the Russian invasion of Ukraine continues, living under the uncertainty has become the new normal for thousands of patients with diabetes who are dependant on insulin.Supporting patients with non-communicable disease is the reality of all disaster situations now, and that added layer of complexity makes coordinating responses even harder.In this podcast, we'll hear how people with diabetes are being supported in Ukraine, and what is being done to improve things, despite the continued fighting.Our guests;Iryna Vlasenko, Vice President of the International Diabetes FederationSlim Slama, unit head for NCD management at the WHO

    Yaroslav Diakunchak, family physician in Brovary, Kyiv.

  • In this week's episode, Helen Macdonald is joined by Joseph Ross, US research editor for The BMJ, and Juan Franco, editor of BMJ EBM.They begin by discussing a review of obesity interventions in primary care, and Joe wonders if GPs are really the best people to tackle the issue.https://www.bmj.com/content/377/bmj-2021-069719 Cervical screening in the UK now includes HPV testing, and they look at research which examines whether this could mean longer periods between screening tests.https://www.bmj.com/content/377/bmj-2021-068776 They all enjoy a new State of the Art Review into Revascularization in stable coronary artery disease.https://www.bmj.com/content/377/bmj-2021-067085Juan and Joe look at a review into combinations of covid-19 vaccinations - and wonder whether we'll ever see more trials to fit into this meta-analysis. https://www.bmj.com/content/377/bmj-2022-069989Finally, they find out how your political persuasion has affected mortality in the US, with new research that links Republican and Democrat voters with differential changes in mortality.

    https://www.bmj.com/content/377/bmj-2021-069308

  • A recent investigation, by The BMJ, showed a worrying increase in incidence of violence, directed to wards GPs, and reported to the police. In this episode of Deep Breath in, Tom and Jenny are joined by Gareth Iacobucci, assistant news editor for The BMJ who broke the story.They'll hear from a GP affected, and get some advice on preventing violence, and deescalation, from two mental health experts, who deal with the most agitated patients. Our guests:Adam Janjua, a GP in Fleetwood, Lancashire.Marcela Schilderman, a consultant psychiatrist at South London and the Maudsley NHS Foundation Trust and Anita Bignell, a mental health nurse, at South London and the Maudsley NHS Foundation TrustReading listViolent incidents at GP surgeries double in five years, BMJ investigation finds

    https://www.bmj.com/content/377/bmj.o1333

  • In Doctor Informed, we've been hearing a lot about the problems of healthcare, but we also want to talk about solutions. Whatever we're going to do to fix healthcare, whether that's bullying, or burnout, or patient safety - it's going to require change. And change is hard. In this episode Clara Munro is joined by Graham Martin, director of research at THIS Institute. They discuss the dreaded phrase "But it's always been done this way", and why failing is the path to success, and the true importance of listening. Our guests;Penny Pereira, Q managing director at the Health Foundation. Q helps promote improvement within the health and care system, encouraging and supporting a wide range of people to effectively lead improvement. https://www.health.org.uk/about-the-health-foundation/our-people/q-and-q-labs-team

    Moira Durbridge, director of safety and risk at University Hospitals of Leicester NHS Trust. Moira trained as a nurse, and continues to work clinically, as well as her role in leading her Trust's change.

  • Helen Macdonald, The BMJ's research integrity editor is back with another episode, and this week is joined by Joe Ross, professor of medicine and public health at Yale, and US research editor for The BMJ, and Juan Franco, editor in chief of BMJ EBM, and Professor at the Instituto Universitario Hospital Italiano de Buenos AiresIn this episode they discuss;The US supreme court looks set to overturn Roe v Wade, creating a patchwork of abortion provision across the U.S. We consider the role which evidence might play in documenting how health is affected by that decision, and whether medical evidence is being used at all in the debate.We'll give you a quick update on treatment for Covid-19We know that trials are needed for new treatments, but in the face of an exponentially growing amount of observational data, is it time for a shift in that certainty? Joe tells us about his research into whether trials and observational studies of three drugs in covid produce the same answer? And finally, treatment variation - it's one of the things that helped kick-start the EBM revolution, but there's still much to learn. Juan describes some new research which examines how countries stack up when you compare their handling of and outcomes of a common condition such as a myocardial infarction.Reading list;Navigating Loss of Abortion Services — A Large Academic Medical Center Prepares for the Overturn of Roe v. Wadehttps://www.nejm.org/doi/full/10.1056/NEJMp2206246.A living WHO guideline on drugs for covid-19https://www.bmj.com/content/370/bmj.m3379Agreement of treatment effects from observational studies and randomized controlled trials evaluating hydroxychloroquine, lopinavir-ritonavir, or dexamethasone for covid-19https://www.bmj.com/content/377/bmj-2021-069400Variation in revascularisation use and outcomes of patients in hospital with acute myocardial infarction across six high income countries

    https://www.bmj.com/content/377/bmj-2021-069164

  • The influence of public health on politics, at least at the beginning of the pandemic, had never been stronger - but now it seems as hard to persuade politicians to pay attention as ever, yet political will is essential in making different sectors work together to create a healthier world.In this podcast, The BMJ's editor in chief, Kamran Abbasi is joined by Shyama Kuruvilla, senior strategic adviser at World Health Organization, and Kent Buse, director of the global healthier societies program at The George Institute for Global Health.They discuss examples of where multisectoral working has managed to bridge the gaps between sectors, and how healthcare needs to get political to make that success more widespread.

    This is part of the collection "The world we want: Actions towards a sustainable, fairer and healthier society" - https://www.bmj.com/pmac-2022

  • This is a special episode of our podcast for GP's, Deep Breath In, where we tackle the everyday challenges of being a GP.With the focus on covid, and the pressure on hospitals, it may be easy to overlook what’s happening in general practice in the UK - but changes are afoot. Our new health secretary Sajid Javid doesn’t seem to like our long standing GP practice arrangement, NHS England has imposed new weekend working arrangements on the already stretched service, and the workforce pressures continue.In this episode of Deep Breath In, our GP panel of Tom Nolan, Navjoyt Ladher, and Jenny Rasanathan are joined by Gareth Iacobucci, The BMJ’s assistant news editor, to give them the lowdown on what’s happening around primary care, who some of the key players are, and what his predictions for 2022.You can find Deep Breath In on all major podcast apps

    https://www.bmj.com/podcasts/deepbreathin

  • Paula Redmond, clinical psychologist who supports healthcare workers experiencing burnout and other difficulties related to their job. Before this, she worked for the NHS until she experienced bullying, and a lack of support from her organisation, which made her strike out on her own.In this wellbeing podcast, she describes the way in which her experience of bullying affected her, and how she used the creative process to help her move on. She and Cat Chatfield discuss what creativity actually is, and why small projects can be just as useful as big complex ones - depending upon what you need at the time.Futher reading:a Blog series on bullying in healthcare: https://drpaularedmond.com/category/bullying_in_healthcare/page/2/

    a mindful embroidery craftivism project ("Do no harm but take no shit") https://drpaularedmond.com/donoharm/

  • Over the course of the last few years, the BMJ has published a series of articles in our Quality Improvement series - aiming to give those new to improvement science a good grasp of how to think about changing things in healthcare.Then covid-19 came along, and it seemed like all of healthcare was now aimed at just surviving in the face of the pandemic, and all thoughts of quality improvement projects went out the window... But did they?Cat Chatfield, is joined by Will Warburton, former director of quality improvement at the Health Foundation, and advisor on the series.

    To read all of the open access articles mentioned in the discussion, visit https://www.bmj.com/quality-improvement

  • In this episode we’re going to be talking about misogyny in surgery, recent revelations about sexual harassment in the theatre have emerged - but these behaviours have been endemic for a while, even as the profession seemed to ignore them.Joining Clara Munro is Baroness Helena Kenned, the author of a recent report into diversity in medicine, who, as a barrister, has long worked on discrimination cases.The reports mentioned in the episode are from the Royal College of Surgeons;

    https://www.rcseng.ac.uk/about-the-rcs/about-our-mission/diversity-review-2021/

  • In this episode of Talk Evidence, Helen Macdonald, the BMJ’s research integrity editor is joined by Joe Ross, US research editor, and Juan Franco, editor in chief of BMJEBM, to talk about all things evidence.Joe gives us an update about covid, including new research on safety of the vaccine Association between covid-19 vaccination, SARS-CoV-2 infection, and risk of immune mediated neurological eventshttps://www.bmj.com/content/376/bmj-2021-068373Juan updates us on a potential new prophylactic for recurrent UTIs, Methenamine hippurate, which could be an alternative to antibiotics.Alternative to prophylactic antibiotics for the treatment of recurrent urinary tract infections in womenhttps://www.bmj.com/content/376/bmj-2021-0068229Helen tells us about some research which evaluates the way in which intersecting identities combine to make students experience of medical school more difficult.Marginalized identities, mistreatment, discrimination, and burnout among US medical students

    https://www.bmj.com/content/376/bmj-2021-065984

  • The issue of food on nightshifts is a perennial grumble in the NHS, and though it might seem trivial, what does it say of an organisation if they demand their staff work when they're hungry, and what is the onward implication for that on patient care?

    To discuss all of these issues, we're joined by Neely Mozawala, a community specialist diabetes podiatrist, and Sahlia Saliha Mahmood-Ahmed, a gastroenterologist who have started the #24hrhotfoodfortheNHS campaign.

  • Medicine is complex, and as a doctor you won't always do the right thing - but you can prepare yourself for when mistakes happen, both emotionally and logistically.In this episode of Doctor Informed, Clara Munro is joined by Susanna Stamford, a patient who was on the receiving end of a mistake, which catalysed her interest in patient safety. We're also joined by Anthea Martin, from Medical Protection, who dispels some myths about saying sorry. Ayisha Ashmore returns to the pod to digest the lessons from our experts.Futher reading:The video that Susanna mentioned is available to watch on youtube

    bitly.com/ManagingAdverseEvents

  • The covid-19 pandemic has stretched healthcare staff like never before. As part of the 2022 Nuffield Trust summit, The BMJ hosted a roundtable discussion looking at why workers leave the NHS and how staff wellbeing and retention can be improved. Joining us to discuss are:Kamran Abbasi, editor in chief, The BMJBilly Palmer, senior fellow, Nuffield TrustLucina Rolewicz, researcher, Nuffield TrustMark Britnell, global healthcare expert and senior partner, KPMG InternationalNeil Greenburg, consultant occupational and forensic psychiatrist, King's College London's centre for military health researchRose Penfold, National Institute for Clinical Research academic clinical fellow in geriatricsRammya Mathew, GP and quality improvement lead for Islington GP FederationPartha Kar, diabetes consultant and NHS England's national advisor for diabetesDanny Mortimer, chief executive of NHS Employers

    The Nuffield Trust report, "The Long Goodbye" which was discussed in this roundtable is available here - https://www.nuffieldtrust.org.uk/resource/the-long-goodbye-exploring-rates-of-staff-leaving-the-nhs-and-social-care

  • In this episode of the podcast we’re going to be talking about rural healthcare - and specifically the difficulties that distance, demographics, and funding have introduced into the world’s covid-19 response.Rural regions made vulnerable by limited healthcare infrastructure, lower rates of vaccination, and opposition to government policies are the new frontlines in the pandemic, but support systems have not adjusted to the growing rural needs for health education, testing, vaccination, and treatment.

    Michael Forster Rothbart, Kata Karáth, and Lungelo Ndhlovu report from the US, Ecuador, and Zimbabwe