This week a very different kind of conversation on the Recommended Dose – one that considers the art of medicine more than the science. Iona Heath is a long-time family doctor who has worked in a London GP clinic for over 30 years, and at one time became President of the Royal College of General Practitioners. With an international profile, gained in part through her much-loved writing in the BMJ, Iona is unlike many of our previous guests. For a start, she loves words more than numbers, and literature more than clinical guidelines. Host Ray Moynihan caught up with Iona at a recent conference in Helsinki – where she'd just presented little data but much food for thought from the likes of novelists EM Forster and James Baldwin. Here, she shares more of her love of literature and thoughtful commitment to the best kind of patient care.
This week Ray sits down with the man best known as the godfather of Evidence Based Medicine (or EBM), Professor Gordon Guyatt. Together they explore the past, present and future of EBM, and look at how an approach encouraging doctors to look more rigorously at the evidence grew into a global reform movement to better inform all our healthcare decisions.
Like most global movements, EBM is not without its critics. Acknowledging this, Gordon shares his thoughts on prominent critiques that argue EBM has been 'hijacked' by commercial interests. And on a more personal note, he reflects on his early dreams of being a novelist, his four tilts at election to Canada's Parliament, and the many ways his two very different parents have shaped his world view.
This week, a very special conversation with a maverick British medico who set up a tiny research centre in Oxford and watched it grow into a global collaboration of over 40,000 people across 130 countries. Three decades on, the Cochrane Collaboration now produces the world's most trusted health evidence that's used by patients, health professionals, researchers and policy makers around the world every day.
Cochrane co-founder Iain Chalmers joins Ray to look back on the origins of the organisation and the extraordinary life of its namesake, Archie Cochrane. Iain also reflects on his work beyond the collaboration - from working in refugee camps in Gaza to teaching children in Uganda how to detect ‘bullshit’ health claims and more recently, establishing the James Lind Alliance. It's no surprise he's received the BMJ’s most prestigious award for a lifetime of achievement in healthcare, along with a knighthood from the Queen.
This week’s guest has led something of a double life, using both medicine and the media to explore and promote the critical role of evidence in healthcare. Now based at the University of Sydney, Alexandra Barratt's journey from clinician to journalist to global advocate for evidence based medicine and shared decision-making is a fascinating one.
Here she talks with Ray about her varied career and the reasons she's ended up challenging conventional wisdom. She also talks about her research into the pros and cons of breast cancer screening and questions the widely-accepted idea that early detection is always the best medicine. For show notes and a complete transcript of this episode, visit australia.cochrane.org/trd.
A familiar voice to millions, Dr Norman Swan is Australia’s best known health reporter. Having presented the ABC’s Health Report for more than three decades, this week he’s on the other side of the microphone.
Norman joins Ray to talk frankly about medicine and the media. He shares some of the joys and challenges of his work inside and outside of the ABC - including his stint as resident medic on commercial TV show The Biggest Loser and his work establishing a private media company that advertises in health clinics across Australia. A multi-award winning journalist and now popular podcaster, the common thread running through Norman Swan's distinguished career is a life-long interest in bringing new ideas, information and evidence to audiences of all kinds.
For a more show details and a full transcript of all our episodes visit www.australia.cochrane.org/trd
This week influential Editor-in-Chief of JAMA Internal Medicine Dr Rita Redberg joins Ray for a wide ranging conversation on all things health. A Professor at the University of California San Francisco and high profile contributor to The Washington Post and New York Times, Rita is also a practising cardiologist who loves to see patients. She says that ‘being a doctor is really a privilege’.
Together, Ray and Rita canvas many topics including shared decision making between doctors and patients, the tricky territory of medical device approvals, the controversy surrounding both statins and CT scans, and the implications of not including enough women in clinical trials.
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 quo. His trailblazing 2005 paper 'Why Most Published Research Findings Are False' has been viewed over 2.5 million times and is the most cited article in the history of PLoS Medicine. In it, he argues that most medical research is biased, overblown or simply wrong. Here, he talks to Ray about the far-reaching implications of these findings for people both inside and outside the world of health.
While most closely associated with exploring cutting-edge conundrums across science, genomics and even economics, John is also something of a humanist. He’d be right at home with the philosophers of ancient Greece, seeking as he does to find answers to the big questions of the day in science and medicine, as well as in nature and narratives.
A voracious reader himself, John has a lifelong love of ‘swimming in books’ and has penned seven literary works of his own in Greek – two of which have been nominated for prestigious literary prizes. And fittingly, he finds inspiration for his myriad of multi-disciplinary pursuits on Antipaxi, one of Greece’s most beautiful and secluded islands.
He shares some of his distinctive logic, reason - and even a little of his poetry - on this very special episode of The Recommended Dose, produced by Cochrane Australia and co-published with the BMJ.
You'll find our show notes and a full transcript of the show at http://australia.cochrane.org/trd
Ray’s guest this week is Julian Elliott - the well-travelled Australian doctor, researcher and big picture thinker who aims to use new technology to radically improve health systems and access to evidence for people around the world – whether they’re in high or low income countries.
Julian is something of a futurist. So at a time when all kinds of websites, apps and wearable devices are ingesting our health and personal data, Ray asks him what the consequences of this ever increasing deluge of data might be. Should we be concerned about how our personal data will be used or hopeful about the promise all this new information holds for understanding and improving human health?
Julian also shares his insights from his early work as a doctor in the Northern Territory and as a HIV specialist in Cambodia. He explains how these experiences continue to inspire his work to bring people, processes and technology together to realise better global health.
For a full transcript of this episode visit https://australia.cochrane.org/trd-julian-elliott-interview-transcript
Hailed as one of the best British novelists writing today, Sarah Moss is our very special literary guest on TRD this week. She joins Ray to explore the intersection between fiction and health, and to talk about the doctors, patients, parents and families she portrays so vividly in her five highly acclaimed novels.
The role of the writer, Sarah says, is to ‘ask hard questions beautifully’. She certainly does this through her own exploration of individual lives and struggles within clearly defined social structures past and present. From the first female doctors to forge careers against incredible odds in the 19th century to the challenges of working mums and stay-at-home dads in the 21st century - the terrain she covers is immense.
Here she talks to Ray about the research and reflection that goes into illuminating both historical and contemporary medical worlds that share common themes and raise critical questions about the way we live today. Her comments on the British National Health Service (the NHS) are timely and heart-felt.
She also shares her thoughts on the diverse origins of her storylines, which include both her personal experiences of early motherhood and her political response to news reports from warzones around the globe.
Sarah’s novels include The Tidal Zone (Granta 2016), Signs for Lost Children (Granta 2015), Bodies of Light (Granta 2014), Night Waking (Granta 2011) and Cold Earth (Granta 2009). She also published a non-fiction book called Names for the Sea: Strangers in Iceland (Granta 2012), which explores her experiences as a resident of Reykjavik.
For a full transcript of this episode visit https://australia.cochrane.org/podcast/sarah-moss-interview-transcript
Psychiatrist and would-be international DJ Prathap Tharyan joins Ray from his home in India this week to explore a fascinating fraction of his work, life and philosophy.
Prathap’s wide-ranging agenda reflects a decidedly down-to-earth and original take on understanding and improving the human condition. Be it tending to victims of the Boxing Day tsunami, ensuring humanistic care for the homeless or working with Wikipedia to get better health information to millions around the globe – people and evidence are always at the very centre of his many and varied activities.
Prathap is a leading advocate for evidence-based approaches in Asia, and his work with people in the midst of humanitarian crises has consistently shown that good intentions are no substitute for good evidence.
For a full transcript of this interview visit https://australia.cochrane.org/trd-prathap-tharyan-interview-transcript
Paul Glasziou (aka The Surfing Professor) joins Ray this week to share insights from his stellar career as both a family doctor in Brisbane and a global evidence guru at Oxford and Bond Universities. He explores big picture health issues like overdiagnosis, overtreatment and the implications of genomic testing, alongside important questions for our everyday health - like how you can find and use evidence and put it to good use when visiting or choosing your own doctor or specialist.
At one point Ray braves a chilly Gold Coast beach at the crack of dawn to find Paul and his close colleague/best surfing buddy Professor Chris Del Mar catching waves, spotting whales and agreeing that fun is actually a surprisingly essential part of serious research work.
For a full transcript of this episode visit https://australia.cochrane.org/trd-paul-glasziou-interview-transcript
This week Professor Jimmy Volmink joins Ray to trace an extraordinary personal and professional journey that defied the odds. From his childhood with little educational opportunity in apartheid South Africa to a stellar international research career, he shares the critical moments, chance meetings and inspiring influences that have shaped his life and work.
Jimmy's journey reflects the incredible social, political and human rights struggles of twentieth century South Africa. His current role at Stellenbosch - one of South Africa’s most pre-eminent universities - is itself a striking testament to the kind of change he has witnessed, worked towards and continues to advocate for. When he applied to study at Stellenbosch back in the 1980s, Jimmy was turned down because he was black. Almost four decades later, he holds the prestigious position of Dean of Medicine and Health Sciences at that very same university. Here, Jimmy shares with Ray how this and many other formative experiences have led to his lifelong, unwavering commitment to support and mentor new generations of students in South Africa, and to keep on 'banging the drum about inequality' to affect real change.
For a full transcript of this episode visit https://australia.cochrane.org/trd-jimmy-volmink-interview-transcript
This week Ray catches up with Professor Lisa Bero - one of the world’s leading experts on industry influence on science. Her groundbreaking research continues to show how the tactics of big tobacco, big pharma and increasingly the food industry influence the decisions of health professionals and distort research findings.
Lisa’s current work looks at how private companies are now influencing public health in areas like obesity. Late last year, it was discovered that her research was being secretly ‘monitored’ by Coca-Cola. Here she talks to Ray about this revelation and various attempts by both the tobacco and pharmaceutical industries to undermine her research over the years. While it has never hampered her work, she is concerned about the chilling effect these kinds of antics might have on younger researchers today.
Lisa also shares her thoughts on leaving California to become a fully-fledged, ocean-swimming Sydneysider, who finds daily inspiration in the story of Charles Perkins – the first Aboriginal graduate of The University of Sydney. She also reflects on her role heading up the global Cochrane research network and underlines the importance of health evidence that’s free from conflicts of interest or commercial influence of any kind.
For more details and links to Lisa's work and media coverage, see our show notes: australia.cochrane.org/trdshownotes
You can also download a full transcript at: https://australia.cochrane.org/trd-lisa-bero-interview-transcript
Described as one of world's most prominent psychiatrists, Dr Allen Frances recently made the controversial claim that 'Donald Trump isn't mad, we are'. In this episode, he shares the thinking behind this now infamous statement that attracted both praise and condemnation from mental health professionals and media around the globe.
In recent years, Allen Frances headed the Taskforce which wrote the 4th edition of the influential psychiatric manual of mental disorders, the DSM. But now he's become one of its loudest critics. In this episode, Allen Frances argues that we're now taking every day experiences that are part of the human condition, overdiagnosing them as mental disorders and prescribing pills when there's not a pill solution for every problem in life.
Allen Frances also talks candidly to Ray about the time when he was the recipient of pharmaceutical company generosity - explaining his feeling now of regret and cautioning young doctors to avoid all financial ties with the industry.
For a full transcript of this episode visit https://australia.cochrane.org/trd-allen-frances-interview-transcript
Named by Reuters as one of the most influential scientific minds of our time, this week’s guest wears many hats and pursues all kinds of surprising interests. Jeremy Grimshaw has earned a global reputation for translating evidence into genuine changes that improve human health. He’s a Professor of Medicine at the University of Ottawa, President of the global Campbell Collaboration and a long-time Cochrane luminary. And as Ray discovers, he can make complex behavioural science, obscure music festivals and Formula 1 racing the most comfortable of companions in the course of just one lively conversation. Here, Jeremy closes out series 2 of the Recommended Dose with his original insights into health and social sciences research, and throws in some top musical tips for good measure.
Who better to kick off a series on all things health and evidence than the exceptional and erudite Editor-in-Chief of The BMJ, Dr Fiona Godlee.
In this episode, Fiona chats to Ray about the BMJ's ongoing and often controversial campaigns to change medicine - and broader society - for the better. She also looks to a future that addresses the distorting influence of industry funding on health evidence and outcomes, and let's us in on what drives and inspires her to achieve so much in her influential role at the helm of one of the world's oldest, most popular and prestigious journals.
For a full transcript of this episode visit: https://australia.cochrane.org/trd-fiona-godlee-interview-transcript
Who's Ray? What's Cochrane? Why listen to The Recommended Dose podcast? This super-quick mini-episode offers a snapshot of what we're all about...
For a full transcript of this episode visit https://australia.cochrane.org/recommended-dose-explainer-episode-transcript