Questions about healthcare

The problem with so many ‘wonder drugs’ is that one is prone to wonder drug fatigue. So is the new prostate cancer drug, abiraterone, lauded on so many front pages today the real thing? “Cancer drug could save the lives of 10,000  a year” says the Times, and it’s a big ‘could’. 

It’s a bit unusual for a study containing only 21 patients and which is in the initial stages (phase I) of testing as a treatment to receive such widespread and enthusiastic publicity. Apparently there was a briefing for journalists (not usually the case for releasing research) which probably contributed to just so many headlines. There are, after all, thousands of small studies published in thousands of medical journals across the world ever week. While some of the comments made by some people approached for views on the study are rightly cautious, I am still concerned that there appears to be an awful lot of enthusiasm about a drug that really is still in the initial stages of its assessment. 

The abstract for the paper is here.  And a conflict of interest: I found at least two more things declared as wonder-type-drugs in the papers today, and I don’t believe in wonder drugs.

I am always dubious about being interviewed (I prefer asking the questions.) I worry about how able I am to say what I mean to say, and often realise there was a better way of saying what I was trying to -  but half an hour after I’ve left the building.

A piece I wrote last year about the ‘cervical cancer vaccine’ attracted attention from both pro-vaccination and anti-vaccination lobbyists. 

Hello. I am a GP in Glasgow and write the Second Opinion column in the FT magazine. My column used to be in the FT Weekend Life and Arts Section, and can be found here .
I am hoping that this blog will be a forum for discussion of some of the myriad problems in healthcare, especially the ones that I think don’t always get a fair hearing – and some that don’t get heard much at all outside of the corridors of the NHS.

For example, some of my recurrent concerns are: Why do we so often ignore the evidence for what healthcare interventions work and what don’t? Does continuity of care matter? Is there any proof that market based provision of healthcare is more efficient? Is the National Institute for Clinical Excellence an example of rational rationing or does it just ascribe a financial worth to life? Should people ever use complementary therapies? Who are independent sources of healthcare information? Why are pharmaceutical companies not legally compelled to publish all of their clinical trial data? Should patients trust doctors? Do we consider risk fairly? Are there any checkups worth having? Are the results of clinical trials fairly reported in the popular media? How should doctors ethically use the placebo effect? Is there such a thing as modern medical professionalism? Are private finance initiatives truly the biggest waste of money the NHS is bankrolling? Should we all know our cholesterol level? Is patient satisfaction a good measure of how good a doctor is? Should universities ever employ PR firms to publicise medical research findings? Is the NHS “a gift economy”? Is it ethical for pharmacists to sell ‘treatments’ that have no, or little, basis in evidence? Can nurses do a doctor’s job better?

I am, you’ll be glad to know, not planning to answer all at once. I am, though, planning to update the blog a couple of times a week, and you can subscribe to an RSS feed here.

And so that I am being honest about my own biases; here they are. I believe whole heartedly in the ethos of the NHS. I get extremely, coffee-spillingly irritated when the radio is on and I hear politicians meddling and muddling in the NHS (again). I get upset when people are misled into overhyped hopes. I hope, and think that most health professionals are motivated by vocation and that most hold to professional values.

Also, I am planning to help to write a second edition of a book, which I’ll write about later (information meantime available here). But since it is (and will be) available online for free I hope that won’t be held against me. Thank you for visiting

margaret.mccartney@ft.com

Margaret McCartney’s Blog

This blog is no longer updated but it remains open as an archive.

A forum on healthcare policy and professional issues, by Glasgow-based GP and FT Weekend columnist Margaret McCartney.

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