Medicine and Science from The BMJ

Join Regina Rabinovich, a malaria elimination expert, as she reveals how China achieved malaria-free status through innovation and persistence. Hui Liu discusses the implications of retracted studies on clinical guidelines, stressing their alarming influence on healthcare practices. Sonia Saxena advocates for a revolution in academic medicine, focusing on curriculum reforms and the need for integrity in research. Together, they outline the importance of collaboration in overcoming global health challenges and transforming medical education.

The UK government is debating legislation to allow assisted dying in England and Wales, which puts doctors at the forefront of deciding if their patient will be eligible for a medically assisted death - the key criteria being a 6 month prognosis. But is making a 6 month prognosis actually clinically reliable? To discuss we're joined by a panel of experts on end of life; Scott Murray, emeritus professor of primary palliative care at the University of Edinburgh Simon Etkind, assistant professor of palliative care at the University of Cambridge Nancy Preston, professor of supportive and palliative care, Lancaster University Suzanne Ost, professor of law, Lancaster University Reading list Assisted dying and the difficulties of predicting end of life Breaching the stalemate on assisted dying: it’s time to move beyond a medicalised approach   Also in this episode, we dim the lights and raise the curtains - there is a public fascination with doctors who kill and the stage show turned podcast, ‘An Appointment with Murder’, takes a deep dive into the crimes of GPs John Bodkin-Adams and Harold Shipman. Kamran is joined by Harry Brunjes and Andrew Johns to talk medical murder. An Appointment With Murder on Apple Podcasts    

Kamran Abbasi interviews Professor Ashish Jha, Dean of Public Health at Brown University and former COVID-19 pandemic advisor to President Biden. Watch this interview on our YouTube. Trump’s second term has touched everything in the US political sphere - and health is no exception. With research funding for medicine and science weathering under Trump’s storm of cuts, how can Americans who care about public health and data navigate a course through the swells? Professor Jha discusses how to resist an anti-vaccine resurgence, and comments on revisionist narratives that drive ill-conceived public health policies.   02:20 The MAHA movement and RFK Jnr. 07:40 Does evidence still matter? 13:35 Trump administration is helping China 15:10 Policymaking in Trump’s shadow 23:35 Where do universities go from here? 28:48 Censorship, research funding and academic freedom 33:35 Health inequalities within America 36:20 A resurgent anti-vax message 41:24 What Ashish’s got wrong about the pandemic response 45:31 When is enough for research data? 47:14 Future hope and how to pushback in smart ways   Reading list: Professor Jha’s December 2024 editorial on the Trump admin’s plans for American healthcare coverage 

The UK’s chancellor has announced a £5bn cut to benefits, much of which will be borne by those on long-term disability allowance. Gerry McCartney, professor of wellbeing economy at Glasgow University explains about why these cuts will not only hurt the most vulnerable, but will be counterproductive to the government's wish to get people back to work. Also, Suzanne O'Sullivan, consultant neurologist and author, joins us to talk about her new book "Age of Diagnosis". The book used clinical cases to explore the issues of medicalisation, and Suzanne explains why overdiagnosis doesn't mean that care isn't needed.   Reading list; UK welfare reforms threaten health of the most vulnerable Guardian edited extract from "The Age of Diagnosis: Sickness, Health and Why Medicine Has Gone Too Far"  

Nigel Crisp, former chief executive of the NHS, emphasizes the importance of aligning healthcare more closely with political decision-makers following the disbanding of NHS England. Illona Kickbusch, professor at the University of Geneva, discusses the impact of U.S. withdrawal from the WHO and the resulting instability in global health alliances. Zulfiqar Bhutta, an expert in global child health, highlights the double burden of malnutrition faced by adolescent girls in South Asia, advocating for societal and governmental change to improve their health outcomes.

Trish Greenhalgh, a leading expert in primary care from Oxford, shares insights from her review on the effectiveness of physician associates in the NHS. Habib Naqvi highlights the ongoing impact of racism in healthcare and the vital need for reform to support ethnic minority patients and professionals. Katie Bramall-Stainer discusses the critical barriers that prevent NHS staff from speaking up, including hierarchical culture and psychological safety issues. Together, they explore solutions to enhance communication and equity in healthcare, making it safer for all.

Phil Banfield, Chair of the British Medical Association's council and an obstetrician in North Wales, shares insights on the BMA's advocacy efforts. He discusses pressing issues like pay restoration and the need for more training posts for resident doctors. The conversation highlights the BMA's evolving strategy to empower local members, tackle NHS challenges, and navigate the complexities of medical negotiations. Additionally, they touch on the role of physician associates and the importance of modernizing industrial action to better represent medical professionals.

Heidi Larson, a professor of anthropology and vaccine communication, joins Martin McKee, a public health expert, and Jane Ballentyne, a chronic pain management specialist. They tackle the urgent issue of health disinformation, exploring its impact on vaccine hesitancy. The conversation pivots to new guidelines against spinal injections for chronic pain, discussing the difficulties this poses for patients and doctors alike. The episode also reflects on progress in combating racism within UK medical schools, emphasizing the need for continued vigilance and change.

Providing quality healthcare is demanding, often stressful, and requires sustained effort. When resources are stretched and pressure mounts, compassion can slip - but compassion is an essential tool for leaders, who need to support their teams to continue delivering the best possible care.   In this final episode of The BMJ’s podcast series on quality of care, Rachael Hinton, BMJ Editor, speaks to three healthcare leaders. They discuss how fostering kind and compassionate leadership and care can improve morale, combat burnout, and contribute to better patient outcomes.   01:48 Lydia Okutoyi talks compassionate leadership in Kenya 08:39 Pedro Delgado talks refocusing on the human factor and tools for kind leadership 15:02 Alexander Ansah Manu talks reaping quality of care benefits in Ghana   This podcast was produced as part of the BMJ Collection on Quality of Care, developed in partnership with the World Health Organisation and the World Bank. Visit bmj.com/qualityofcare to view the full Collection. The BMJ commissioned, edited, and published this podcast. This episode edited by Brian Kennedy.  

Joining the conversation are May van Schalkwyk, a researcher at Edinburgh University specializing in industry influence on public health, and Karim Lekadir, a nuclear research professor at the University of Barcelona focusing on AI in healthcare. They delve into the tactics used by fast-food giants like McDonald's to thwart health regulations near schools, drawing unsettling parallels to the tobacco industry. They also discuss new guidelines for trustworthy AI applications in healthcare, stressing the importance of ethical practices and stakeholder collaboration in enhancing patient care.