The BMJ Podcast

Helen Macdonald, The BMJ's research integrity editor is back with another episode, and this week is joined by Joe Ross, professor of medicine and public health at Yale, and US research editor for The BMJ, and Juan Franco, editor in chief of BMJ EBM, and Professor at the Instituto Universitario Hospital Italiano de Buenos Aires

In this episode they discuss;

The US supreme court looks set to overturn Roe v Wade, creating a patchwork of abortion provision across the U.S. We consider the role which evidence might play in documenting how health is affected by that decision, and whether medical evidence is being used at all in the debate.

We'll give you a quick update on treatment for Covid-19

We know that trials are needed for new treatments, but in the face of an exponentially growing amount of observational data, is it time for a shift in that certainty? Joe tells us about his research into whether trials and observational studies of three drugs in covid produce the same answer?

And finally, treatment variation - it's one of the things that helped kick-start the EBM revolution, but there's still much to learn. Juan describes some new research which examines how countries stack up when you compare their handling of and outcomes of a common condition such as a myocardial infarction.

Reading list;

Navigating Loss of Abortion Services — A Large Academic Medical Center Prepares for the Overturn of Roe v. Wade

https://www.nejm.org/doi/full/10.1056/NEJMp2206246.

A living WHO guideline on drugs for covid-19

https://www.bmj.com/content/370/bmj.m3379

Agreement of treatment effects from observational studies and randomized controlled trials evaluating hydroxychloroquine, lopinavir-ritonavir, or dexamethasone for covid-19

https://www.bmj.com/content/377/bmj-2021-069400

Variation in revascularisation use and outcomes of patients in hospital with acute myocardial infarction across six high income countries

https://www.bmj.com/content/377/bmj-2021-069164

The influence of public health on politics, at least at the beginning of the pandemic, had never been stronger - but now it seems as hard to persuade politicians to pay attention as ever, yet political will is essential in making different sectors work together to create a healthier world.

In this podcast, The BMJ's editor in chief, Kamran Abbasi is joined by Shyama Kuruvilla, senior strategic adviser at World Health Organization, and Kent Buse, director of the global healthier societies program at The George Institute for Global Health.

They discuss examples of where multisectoral working has managed to bridge the gaps between sectors, and how healthcare needs to get political to make that success more widespread.

This is part of the collection "The world we want: Actions towards a sustainable, fairer and healthier society" - https://www.bmj.com/pmac-2022

This is a special episode of our podcast for GP's, Deep Breath In, where we tackle the everyday challenges of being a GP.

With the focus on covid, and the pressure on hospitals, it may be easy to overlook what’s happening in general practice in the UK - but changes are afoot. Our new health secretary Sajid Javid doesn’t seem to like our long standing GP practice arrangement, NHS England has imposed new weekend working arrangements on the already stretched service, and the workforce pressures continue.

In this episode of Deep Breath In, our GP panel of Tom Nolan, Navjoyt Ladher, and Jenny Rasanathan are joined by Gareth Iacobucci, The BMJ’s assistant news editor, to give them the lowdown on what’s happening around primary care, who some of the key players are, and what his predictions for 2022.

You can find Deep Breath In on all major podcast apps

https://www.bmj.com/podcasts/deepbreathin

Paula Redmond, clinical psychologist who supports healthcare workers experiencing burnout and other difficulties related to their job. Before this, she worked for the NHS until she experienced bullying, and a lack of support from her organisation, which made her strike out on her own.

In this wellbeing podcast, she describes the way in which her experience of bullying affected her, and how she used the creative process to help her move on.

She and Cat Chatfield discuss what creativity actually is, and why small projects can be just as useful as big complex ones - depending upon what you need at the time.

Futher reading:

a Blog series on bullying in healthcare: https://drpaularedmond.com/category/bullying_in_healthcare/page/2/

a mindful embroidery craftivism project ("Do no harm but take no shit") https://drpaularedmond.com/donoharm/

Over the course of the last few years, the BMJ has published a series of articles in our Quality Improvement series - aiming to give those new to improvement science a good grasp of how to think about changing things in healthcare.

Then covid-19 came along, and it seemed like all of healthcare was now aimed at just surviving in the face of the pandemic, and all thoughts of quality improvement projects went out the window... But did they?

Cat Chatfield, is joined by Will Warburton, former director of quality improvement at the Health Foundation, and advisor on the series.

To read all of the open access articles mentioned in the discussion, visit https://www.bmj.com/quality-improvement

In this episode we’re going to be talking about misogyny in surgery, recent revelations about sexual harassment in the theatre have emerged - but these behaviours have been endemic for a while, even as the profession seemed to ignore them.

Joining Clara Munro is Baroness Helena Kenned, the author of a recent report into diversity in medicine, who, as a barrister, has long worked on discrimination cases.

The reports mentioned in the episode are from the Royal College of Surgeons;

https://www.rcseng.ac.uk/about-the-rcs/about-our-mission/diversity-review-2021/

In this episode of Talk Evidence, Helen Macdonald, the BMJ’s research integrity editor is joined by Joe Ross, US research editor, and Juan Franco, editor in chief of BMJEBM, to talk about all things evidence.

Joe gives us an update about covid, including new research on safety of the vaccine Association between covid-19 vaccination, SARS-CoV-2 infection, and risk of immune mediated neurological events

https://www.bmj.com/content/376/bmj-2021-068373

Juan updates us on a potential new prophylactic for recurrent UTIs, Methenamine hippurate, which could be an alternative to antibiotics.

Alternative to prophylactic antibiotics for the treatment of recurrent urinary tract infections in women

https://www.bmj.com/content/376/bmj-2021-0068229

Helen tells us about some research which evaluates the way in which intersecting identities combine to make students experience of medical school more difficult.

Marginalized identities, mistreatment, discrimination, and burnout among US medical students

https://www.bmj.com/content/376/bmj-2021-065984

The issue of food on nightshifts is a perennial grumble in the NHS, and though it might seem trivial, what does it say of an organisation if they demand their staff work when they're hungry, and what is the onward implication for that on patient care?

To discuss all of these issues, we're joined by Neely Mozawala, a community specialist diabetes podiatrist, and Sahlia Saliha Mahmood-Ahmed, a gastroenterologist who have started the #24hrhotfoodfortheNHS campaign.

Medicine is complex, and as a doctor you won't always do the right thing - but you can prepare yourself for when mistakes happen, both emotionally and logistically.

In this episode of Doctor Informed, Clara Munro is joined by Susanna Stamford, a patient who was on the receiving end of a mistake, which catalysed her interest in patient safety. We're also joined by Anthea Martin, from Medical Protection, who dispels some myths about saying sorry. Ayisha Ashmore returns to the pod to digest the lessons from our experts.

Futher reading:

The video that Susanna mentioned is available to watch on youtube

bitly.com/ManagingAdverseEvents

The covid-19 pandemic has stretched healthcare staff like never before. As part of the 2022 Nuffield Trust summit, The BMJ hosted a roundtable discussion looking at why workers leave the NHS and how staff wellbeing and retention can be improved.

Joining us to discuss are:

Kamran Abbasi, editor in chief, The BMJ

Billy Palmer, senior fellow, Nuffield Trust

Lucina Rolewicz, researcher, Nuffield Trust

Mark Britnell, global healthcare expert and senior partner, KPMG International

Neil Greenburg, consultant occupational and forensic psychiatrist, King's College London's centre for military health research

Rose Penfold, National Institute for Clinical Research academic clinical fellow in geriatrics

Rammya Mathew, GP and quality improvement lead for Islington GP Federation

Partha Kar, diabetes consultant and NHS England's national advisor for diabetes

Danny Mortimer, chief executive of NHS Employers

The Nuffield Trust report, "The Long Goodbye" which was discussed in this roundtable is available here - https://www.nuffieldtrust.org.uk/resource/the-long-goodbye-exploring-rates-of-staff-leaving-the-nhs-and-social-care