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Found 490 results
  1. Content Article
    The distribution of malpractice claims among physicians is not well understood. If claim-prone physicians account for a substantial share of all claims, the ability to reliably identify them at an early stage could guide efforts to improve care. Using data from the National Practitioner Data Bank, Studdert et al. analysed 66,426 claims paid against 54,099 physicians from 2005 through 2014. The authors calculated concentrations of claims among physicians. They found over a 10-year period, a small number of physicians with distinctive characteristics accounted for a disproportionately large number of paid malpractice claims.
  2. Content Article
    The aim of this study from Bismark et al. was to identify characteristics of doctors in Victoria, Australia, who are repeated subjects of complaints by patients.
  3. Content Article
    A systematic review and meta-analysis from Hodkinson et al. examines the association of physician burnout with the career engagement and the quality of patient care globally. A joint team of British and Greek researchers analysed 170 previous observational studies of the links between burnout among doctors, their career engagement and quality of patient care. Those papers were based on the views and experience of 239,246 doctors in countries including the US, UK and others in Africa, Asia and elsewhere globally. This meta-analysis provides compelling evidence that physician burnout is associated with poor function and sustainability of healthcare organisations primarily by contributing to the career disengagement and turnover of physicians and secondarily by reducing the quality of patient care. Healthcare organisations should invest more time and effort in implementing evidence-based strategies to mitigate physician burnout across specialties, and particularly in emergency medicine and for physicians in training or residency. Read accompanying BMJ editorial here.
  4. Content Article
    In order to become competent clinicians, doctors need to appropriately calibrate their clinical reasoning, but lack of follow-up after transitions of care can present a barrier to this. This study in the Journal of Hospital Medicine aimed to implement structured feedback about clinical reasoning for residents performing overnight admissions, measure the frequency of diagnostic changes, and determine how feedback impacts learners' self-efficacy. The authors concluded that structured feedback for overnight admissions is a promising approach to improve residents' diagnostic calibration, particularly given how often diagnostic changes occur.
  5. Content Article
    Patient safety culture is a vital component in ensuring high-quality and safe patient care. This cross-sectional study aimed to assess doctors’ and nurses’ perceptions of patient safety culture in five public general hospitals in Hanoi, Vietnam. The study found that the mean scores among nurses were significantly higher than that among physicians for several categories: supervisor/manager expectations staffing management support for patient safety teamwork across units handoffs and transitions Nurses reported significantly higher patient grades than physicians (75% vs 67.1%) and around two-thirds of physicians and nurses reported no event in the past 12 months (62.8 and 71.7% respectively). The authors recommend that hospitals develop and implement intervention programs to improve patient safety, including around teamwork and communication, encouraging staff to notify incidents and avoiding punitive responses.
  6. Content Article
    Everybody makes mistakes at work but what if you're a doctor and you ruin a patient's life - or even end it? Doctor-turned-writer Jed Mercurio recalls a catalogue of errors from his years as a medical student.
  7. Content Article
    This report by the Academy of Medical Royal Colleges looks at the possibilities for establishing a system of staggered changeover start dates for trainee doctors. Evidence suggests that there is an increase in patient morbidity and mortality at the beginning of August each year, which corresponds with the time when trainee doctors rotate positions. The paper, produced by the Academy’s Staggered Trainee Changeover Working Group (STCWG), recommends that the most effective solution for safe trainee changeover is a roll forward model of staggering, where the more senior trainees rotate one month later. A survey of Foundation doctors demonstrated support for a system where all Specialty Training programmes start at the beginning of September, one month after the end of the Foundation Programme.
  8. Content Article
    The General Medical Council (GMC) is the UK's statutory body responsible for taking action to prevent a doctor from putting the safety and confidence of patients at risk. In this blog for The Spectator, doctor Max Pemberton argues that the GMC has lost the trust of doctors by bringing a series of inappropriate cases, resulting in the British Medical Association (BMA) calling for an overhaul of how the GMC is run. He describes some recent investigations as being about 'petty' issues and highlights the significant impact being under investigation can have on doctors' mental health.
  9. Content Article
    Over the last four years, Health Education England (HEE) has led a collaborative effort, on behalf of patients, the profession and the NHS, to co-create reforms across medical education and training. HEE launched the Future Doctor Programme last year, linked to work on the NHS People Plan, to inform and galvanise change in medical education and training to achieve the vision for future healthcare as set out in the NHS Long Term Plan. The Future Doctor Programme provides a clear view of what the NHS, patients and the public require from future doctors within a transformed multi-professional team. This co-created vision for the future has also identified much of what is required to respond to the projected demands and needs of the workforce in the future.
  10. Content Article
    Laurence Goldberg, an independent pharmaceutical consultant, discusses the effectiveness and also the potential for harm of unit-dose medicines distribution.
  11. Content Article
    Clinicians play an essential role in implementing infection prevention policy, but little is known about how infection control policy is implemented at an organisational level or what factors influence this process. This study explores the policy implementation process used in the introduction of a national large-scale, government-directed infection prevention policy in Australia.
  12. Content Article
    The aim of this study from H R Guly was to describe the injuries misdiagnosed as a sprain of the wrist and to determine the approximate incidence of misdiagnosis in patients diagnosed as having a sprain of the wrist. In total 57 injuries initially diagnosed as a sprained wrist had a different diagnosis (1.76% of all diagnoses of sprained wrists). This is an underestimate of the true incidence of diagnostic error. Forty two per cent of the misdiagnoses were of greenstick or torus fractures of the distal radius. Guly concluded that training for junior doctors in A&E departments should be improved—especially training in radiological interpretation. Other methods of preventing diagnostic errors by misreading of radiographs, for example, more hot reporting of radiographs by radiologists or radiographers should be considered.
  13. Content Article
    This research explores how the COVID-19 pandemic has changed the ways doctors make end-of-life decisions, particularly around Do Not Attempt Cardio-Pulmonary Resuscitation (DNACPR), treatment escalation and doctors’ views on the legalisation of euthanasia and physician-assisted suicide.
  14. Content Article
    David Oliver is a consultant in geriatrics and acute general medicine who has worked in the NHS for 33 years. In this blog, he talks about his personal experience of running covid 'hot' wards during the different waves of the pandemic, describing the toll working in these conditions has taken on the health of him and many of his colleagues. He highlights the impact of looking after dying patients without adequate PPE, informing family members of patients' death over the phone, being responsible for many more patients than usual and witnessing colleagues die from Covid-19. The result has been burnout, mental health issues and low morale for a workforce that was already stretched before the pandemic hit the UK. David finally caught Covid-19 himself in March 2022 and he talks about how the virus—plus the cumulative effect of working under such strain for over two years—has meant he is not able to work and has been signed-off sick since mid-May.
  15. Content Article
    This article in Computer Weekly outlines the tribunal proceedings and judgement in high-profile case brought by whistleblower Chris Day. Dr Day claimed that Lewisham and Greenwich NHS Foundation Trust had concealed evidence when a director deleted up to 90,000 emails before he was due to testify at an earlier tribunal, concerning allegedly false and detrimental public statements about Dr Day made by the Trust. Dr Day’s lengthy legal battle first began when he was a junior doctor working at Queen Elizabeth Hospital Woolwich’s intensive care unit in 2013, where he spoke up about under-staffing at the ICU.
  16. Content Article
    Moral injury is a specific kind of trauma that can happen when when people face situations that deeply violate their conscience or threaten their core values. This blog for Scientific American looks at the experience of ER doctor Torree McGowan when the Delta wave of Covid-19 hit the central Oregon region where she works. It examines the impact that moral injury has had on her mental health and her relationship with patients. The author looks at how Covid-19 hugely increased the incidence of moral injury as people in frontline roles faced ethically wrenching dilemmas every day. The growing realisation that moral injury is a separate diagnosis to other conditions such as PTSD and depression is resulting in a wider range of treatments and trauma therapies. Many of these treatments encourage people to face moral conflicts head-on rather than blotting them out or explaining them away, and they emphasize the importance of community support in long-term recovery.
  17. Content Article
    Everyone has the right to come to work without fear of racism. This resource from the General Medical Council (GMC) provides advice on how our guidance principles on non-discrimination apply when tackling racism. Where racist behaviour occurs among colleagues and patients, we recognise the fear that many doctors have of reporting these incidents. It signposts a range of support channels and highlights the duties we expect of doctors in senior positions in tackling and rooting out discrimination where it arises. It includes case studies from doctors and others on their experiences, advice and best practice.
  18. Content Article
    This opinion piece in the BMJ by Partha Kar, Director of Equality for Medical Workforce in the NHS, explores racial inequalities in the NHS workforce. Partha is currently leading work on the Medical Workforce Race Equality Standard (MWRES), which aims to challenge trusts and systems openly and transparently about race-based inequalities faced by NHS doctors.
  19. Content Article
    NHS chiefs and regulators have written to hospital bosses admitting winter could be so bad NHS staff may have to "depart from established procedures" to care for patients. Letter says regulators will take the challenging situations into context...
  20. Content Article
    Emer Joyce is a Cardiologist at Mater University Hospital in Dublin who developed myocarditis as a result of a Covid-19 infection. This article by Professor Joyce in the European Journal of Heart Failure aims to "give a birds-eye view of the physician as patient, the sub-specialist as sub-specialist condition sufferer, the one on the far side of the bed as the one in the bed." She also looks at the pattern of previously healthy, highly active healthcare professionals developing serious long-term health issues as a result of Covid-19.
  21. Content Article
    Earlier this year, information technology (IT) systems at one of the largest hospital trusts in the NHS stopped working for 10 days. This was the latest in a long history of NHS IT system failures across primary and secondary care. As “paperless” is now the default operating mode for many healthcare systems globally, IT failures block access to records, prevent clinicians from ordering investigations, restrict service provision, and bring to a halt the everyday business of healthcare. Increasing digital transformation means such failures are no longer mere inconvenience but fundamentally affect our ability to deliver safe and effective care. They result in patient harm and increased costs. There is a growing disconnect between government messaging promoting a digital future for healthcare (including artificial intelligence) and the lived experience of clinical staff coping daily with ongoing IT problems., writes Joe Zhang and Hutan Ashrafia in a BMJ Editorial. Digital capabilities exist in a strict hierarchy, with IT infrastructure as the foundational layer. This digital future will not materialise without closer attention to crumbling IT infrastructure and poor user experiences. 
  22. Content Article
    When Joe Fassler's wife was struck by mysterious, debilitating symptoms, their trip to the ER revealed the sexism inherent in emergency treatment.
  23. Content Article
    We need a public register to show if healthcare professionals are in the pay of industry – or more patients will suffer, writes Margaret McCartney following the publication of the Independent Medicines and Medical Devices Safety Review. Hospitals in England are meant to publish registers of interest of staff – but a 2016 study shows that only a minority give the details they should. A publicly accessible digital register, updated at least annually and compelled by the regulator, would create transparency and get rid of the huge amount of work that campaigners have had to do to untangle where conflicts lie. Declarations alone can’t sort the problems of conflicted medicine. But a public register would allow us to know whose advice isn’t independent. We will still need to be alert to the unintended consequences of a register, and research will be needed. The UK is lagging behind. Kath Sansom, a journalist who founded the Sling the Mesh campaign, told Margaret: “I had no idea that I couldn’t trust my doctor or surgeon to give the best advice. It is essential that medics declare industry funding.”
  24. Content Article
    The aim of this paper is to raise awareness of the impact menopause is having on the workforce, as well as to issue recommendations and help healthcare organisations, managers, and employers to better support health care workers so that they do not leave the workforce or suffer in silence if they struggle with managing menopause symptoms.
  25. Content Article
    While many physicians may avoid discussing the subject, a study showed that who gets addressed with the honorific “Dr.” may depend on gender, degree and specialty.
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