Saturday, 7 June 2014

Medical Super Specialisation is good AND bad for patients!

  • This is an interesting article suggesting that if a surgeon specialises in one type of operation and therefore carries out a large number of them per year, his patients are less likely to suffer complications. 
  • In an age when patient outcomes are important, this strengthens the case for further specialisation in different disciplines of surgery. In my specialty, cardiac surgery for example, there are moves now for surgeons just to specialise in surgery of the mitral valve or surgery of the aorta. If I was a patient with mitral valve disease, I know who I would want to operate on my mitral valve . 
  • There are however tensions and problems associated with increasing specialisation.

Saturday, 17 May 2014

When Modern Tech Makes it all Worthwhile.

I was listening recently to 8tracks online radio in my car.  It is one of the better online radio stations because it is intuitive to use and allows you to create libraries of tracks you like and are able to share with others. If you love music, online streaming stations, which include Bloom FM and others are must have apps on your smartphone.  The combination of these apps on your phone, a unlimited data contract with your mobile phone provider and the ability to link via bluetooth with your in-car audio is one of modern life's great treats
During a recent drive home, I heard a beautiful piano tune called I Giorni by Ludovico Einaudi. It seemed immediately familiar to me. Mr. Google subsequently informed me that it has been used by the BBC for one of their own ads to highlight Arts programmes. It has also been used in a television ad in India for Airtel, a mobile comms company.

Anyway, enjoy.

Friday, 16 May 2014

Is this a Wonder Prosthesis?

Reduced anticoagulation after mechanical aortic valve replacement: Interim results from the Prospective Randomized On-X Valve Anticoagulation Clinical Trial randomized Food and Drug Administration investigational device exemption trial

Cardiac surgeons, industry and increasingly patients with heart valve disease, are always on the lookout for the perfect  heart valve prosthesis.
There are 2 main types of prostheses that are used to replace diseased valves, mechanical and biological.

Opening the Doors on Animal Testing


I am so pleased that we are where we are in the UK with animal testing.  I used to get depressed and angry in equal measures at the frequent stories of harassment and violence by anti-vivisection demonstrators 20 or so years ago.
It is to the credit of Tony Blair and Sheffield's David Blunkett (home secretary at the time), who changed the law making such violence a very serious offence, that we are in the happier position we are in today. Openness is good and will only strengthen the backing of the public for sensible animal testing. This is crucial if the wish of successive governments that Britain must remain at the forefront of biomedical research is to be realised. 

Friday, 25 April 2014

The Land of Opportunity ?

The nomination by the president Obama of Vivek Hallegere Murthy as America's surgeon general ( Public Health top doc) just further illustrates to me the heights professionals of the Indian diaspora are able to scale in the United States. See here , here , here and here
It is difficult to state such a fact without sounding unpleasantly condescending - that is not my  intention. The reason for my observation is that India has a far greater historical connection with the United Kingdom. Nonetheless it is in the United States, the land of opportunity that people of Indian origin have really shined and made a global impact. This is not to say that there is no racism or discrimination in the US. Like everything else in life, the boundaries that exist in the US are far greater, there is both more discrimination AND more opportunity - stifling poverty with no health cover (until now that is) for many African Americans as well as the position of Commander - in - Chief.

ps The blocking of the nomination of Dr. Murthy by the NRA is quite extraordinary. Not only do they want guns promoted, they want a top doc who agrees with them!!! 

Monday, 21 April 2014

Do We Really Need 4 Colleges of Surgery?

This YouTube video features a unique set of talks from the presidents of all surgical colleges in the UK. They were given at the recent annual meeting of the Association of Surgeons in Training in Belfast.
Most training and assessment (including examinations) is now intercollegiate i.e. one exam for all colleges and is handled by newly created intercollegiate bodies.
One wonders sometimes therefore what is the point of having different colleges ?
All the British/Irish colleges were formed centuries ago and are steeped in history. It does seem reckless I suppose to do away with several centuries of surgical tradition and pomp. 
Alot of useful inter-collegiate work takes place but when one sees the real challenges facing surgery and surgeons today, a lot of more is needed.
Maybe when all four colleges have women presidents, things will really change and old boy clubs and ties will become relics of the past!

If the Edinburgh college can get a base in Birmimgham, how about a base in Yorkshire for the English College? - Are you listening Claire?