Your weekly BMJ digest – 1/4/17

It’s coming up to that time of the year again – speciality applications are looming and you realise with guilt that you haven’t opened any of your BMJs since the last time you had to prepare for an interview. There they are, stacked by the loo, looking ever so intellectual for when non-medic friends come to visit.

“Oh those old things?” you say, when a friend comments. “Just trying to keep up to date. Medicine involves a lifetime of learning.”

“Why are they still in their plastic wrappers then?” comes the annoying reply.

Well, fear not. is here to make your life a little easier. I have read this week’s BMJ and broken it down so you don’t have to. Thank heavens half of the BMJ is job adverts.

Here we go:

Cover Story: A productive NHS – Studies by the Health Foundation have shown that Consultant productivity (um, what is that? Well, one crude measure of it is elective activity) has fallen by an average of 2.3% over 6 years. Put simply – yes, there are 22% more Consultants but elective activity hasn’t kept up, leading to an actual decrease in overall productivity using this measure.

BUT the caveat to that is the difficulty in measuring “productivity”. Surely it means more than just elective activity? How do you combine all sorts of bits of productivity e.g. teaching, clinic times etc into one big measure? Furthermore, as Medicine evolves everything becomes more complex, so can we even directly compare an “elective activity” of today with those of 6 years ago? As with most difficult questions, the answers only lead to more questions.

There is, however, a correlation between hospitals with lower Consultant output (crude though the measure of elective activity may be) and lower numbers of nurses, lower pay rates and increased delays in transfer of care. It’s what you would intuit – system failures and poor workforce planning are not good for efficient and effective care. Even the BMJ goes “duh” on this one saying “none of this is rocket science.”

Best of the Rest: Another brilliant idea Jeremy – Our esteemed Health Secretary, Jeremy Hunt, is floating the idea of an annual Who Wants to be a Millionaire-style MCQ test for all healthcare professionals to take. Presumably this will ascertain and more importantly, quantify how safe/knowledgeable/dedicated they are. I doubt there’ll be a million pounds if you get all the answers right though.

The Major Incident Moment – This short perspective piece interviews one of the doctors involved in treating victims of last week’s terrorist incident in Westminster. It’s a powerful reminder about how unfortunately sometimes the unthinkable does happen and how important preparing for it is.

You think A&E is bad – Spare a thought for doctors in India. A 2015 Indian Medical Association survey found that 75% of Indian doctors had experienced violence in the workplace. With a spate of recent assaults, Indian doctors are calling for more measures to ensure their safety. Damn right.

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