Medicine and Science from The BMJ

Why compassion isn't just nice, it's essential

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.
 

The industry playbook to combat public health, and FUTURE-AI

This week Rebecca Coombes is back with another big-food investigation, this time about fast-food giant MacDonalds subverting attempts to stop it opening stores near schools.
Sticking with industry behaving badly, May van Schalkwyk, from the University of Edinburgh, wonders why we haven't learn lessons from the attempts to control big tobacco companies, when it comes to other industries that harm health.
And finally, AI in healthcare - Karim Lekadir, from the University of Barcelona, explains new guidelines which can help evaluate which AI applications are trustworthy.
 
Reading list
McDonald’s triumphs over councils’ rejections of new branches
FUTURE-AI: international consensus guideline for trustworthy and deployable artificial intelligence in healthcare

Prehabilitation before surgery, alcohol's impact on clinical care, and life after a cardiac arrest

Exercise and a better diet, prior to surgery, can improve outcomes. Daniel McIsaac, a professor of anaesthesiology from the University of Ottowa and lead author of that research, joins us to talk about getting those results into practice.
Julia Sinclair, professor of addiction psychiatry at the University of Southampton, explains how the NHS has lost sight of the impact alcohol consumption has on clinical care, and why we need a strategy to tackle it.
Finally, Matt Morgan, consultant in intensive care and BMJ columnist, has written another book - this time about patients who are revived after cardiac arrest, and the profound effect it can have on their outlook in life. 
 
Reading list:
Relative efficacy of prehabilitation interventions and their components
UK needs national strategy to tackle alcohol related harms
A Second Act
 

Can a deal be done to keep the US in the WHO?

US President Donald Trump has signed an executive order to withdraw the US out of the WHO. This would cut funding for the UN’s medical agency by one-fifth.
Will they really exit, or can a deal be made? Lawrence Gostin hopes so, and as a professor of law at Georgetown, and director of the World Health Organisation Collaborating Center on National and Global Health Law, he is working with senior US and WHO officials to try and understand what reforms could be made to WHO what would allow a such a deal to be be struck.
Gostin also believes that the president cannot withdraw from the WHO with an executive order, but instead requires congressional approval - and is exploring the options for legal challenge to the move.
 
00:00 Intro
01:01 US history with the WHO
03:31 Executive order
06:35 WHO’s relationship with China
11:14 Funding
12:47 Benefits to US from the WHO
18:05 H5N1 threat
19:43 World benefits from US involvement
21:57 A deal to be made?
24:55 Legal action?
26:37 Administration responses
 
Read Professor Larry Gostin’s co-written opinion piece on the dangers of a US withdrawal from the WHO here: https://www.bmj.com/content/388/bmj.r116

Conviviality and TV doctors, polar bear tales, and Christmas research

In the last podcast of 2024, Richard Smith, former editor of The BMJ and head of UKHACC will be making the case for being more convivial. Tina Korownyk, professor of family medicine at the University of Alberta is the ghost of Christmas past for TV doctors.
Tim Feeny and Navjoyt Ladher take us through this year's Christmas research papers.
And finally, Mari Martensen, a paramedic, explains what makes being a medic in Svalbard bear-able.
 
Reading list.
The dangers of industrialisation—why we need to rebuild a convivial society
Televised medical talk shows—what they recommend and the evidence to support their recommendations
Christmas 2024: How to transport a polar bear, and other idiosyncrasies for Arctic emergency medical services
The full Christmas archive

Big food infiltration of UK Schools, and chocolate consumption and diabetes

Conflicts of interest harm health, and a new investigation uncovers the infiltration of big food manufacturers into UK schools. Emma Wilkinson reports on that investigation. Kamran and  Rebecca Coombes, head of journalism, discuss moves to reduce industry's impact on food policy in the UK.
A new research paper has identified a link between eating chocolate and lower rates of diabetes. Binkai Liu, doctoral student and Qi Sun, associate professor, at the Harvard T.H. Chan School of Public Health explain what they found.
Finally, Sam Hutt is a doctor in the NHS, but is better known by his stage persona “Hank Wangford”. Hank performed a celebration of the NHS at Glastonbury this year, and has now released that song. He joins us to talk about what inspired him.
 
Reading list
Food industry has infiltrated UK children’s education: stealth marketing exposed
Chocolate intake and risk of type 2 diabetes
Hank Wangford

"Incredibly distressing and incredibly dangerous"- David Miliband on healthcare attacks, and staff turnover effect on patient outcomes

In today’s episode, new research, which has looked at the impact staff turnover is having on patient outcomes. Giuseppe Moscelli, associate professor at the University of Surrey joins Navjoyt Ladher to explain more.
 
Also, every year the BMJ has a Christmas appeal - and this year we have chosen the International Rescue Committee as our partner. To talk more about what they do, and to give us some insight into how geopolitics are affecting health we're joined David Milliband, president and chief executive officer of the International Rescue Committee, and former UK foreign secretary.
 
Reading list;
Nurse and doctor turnover and patient outcomes in NHS acute trusts in England
The BMJ Appeal 2024-25: David Miliband on hospital attacks, Trump, and the International Rescue Committee in a “flammable world”

How MSF maintains neutrality in conflict zones

This week we’re at the World Innovation Summit for Health, where we’re a media partner - the meeting is focussing on conflict, equity and resilience. 
In that vein, we’re joined by Christos Christou, international president of Médecins Sans Frontières (MSF) to talk about attacks on healthcare staff, and the difficulty and importance of maintaining neutrality in conflict zones.
Ara Darzi, surgeon, executive chair of the conference, and author of the recent NHS review, joins us to talk about  antimicrobial resistance, and how diagnostics and a small funding commitment could head off the problem.
And finally, we change our focus to the US, and hear about new research into adverse events during surgery with authors Antoine Duclos and David Bates from Harvard Medical School.
 
Reading list.
 
We need to do more to keep antibiotics working
WISH report - Tackling Antimicrobial Resistance: How to Keep Antibiotics Working for the Next Century
Safety of inpatient care in surgical settings: cohort study

Conflict zones, women’s health research, and reimagining palliative care

In this episode, we speak to the doctor overseeing the WHO’s emergency response for the eastern mediterranean region - including Gaza, Lebanon, Sudan and Yemen. Richard Brennan joins us to talk about protecting health services, and workers, in the escalating armed conflicts that are affecting the region.
Menaka Paranathala and Emma Rourke, from The BMJ, are on to talk about improving research into women’s health. A new UK project, MESSAGE, aims to give consideration to sex and gender in life science research.
Palliative care is not just for end-of-life, and rethinking how it’s integrated into every speciality is the key to improving care for patients, argue Richard Harding, Anna Peeler, and Oladayo Afolabi from the Cicely Saunders Institute.
Links
WISH report - Protecting Health in Armed Conflict
MESSAGE (Medical Science Sex and Gender Equity) project
BMJ Opinion - Palliative care is an overlooked global health priority
WISH report - Palliative Care

Climate leadership - knowledge is power

It’s an often cited statistic that if healthcare was a country, it would be the fifth largest carbon emitter. At The BMJ we want to change that, and move healthcare towards a more sustainable future. 
In this week’s episode, we’ll hear about our annual climate edition from two of The BMJ’s editors, Sophie Cook and Juliet Dobson. 
We’ll be diving into Cli-Fi and asking how climate fiction can galvanise our collective response to climate change. Our panel includes Howard Frumkin, professor emeritus at University of Washington. Lakshmi Krishnan, internist and Director of Medical Humanities at Georgetown university, and Sarah Grossman, journalist and author of Fire So Wild.
And Finally, Tereza Kasaeva, director of the WHO’s Global Tuberculosis Programme, explains how migration and food insecurity, exacerbated by climate change, are affecting TB - and why, despite effective treatment, there are still over a million deaths from the disease annually. 
 
Our panel's cli-fi book recommendations
A Fire So Wild - Sarah Grossman
The Last Man - Mary W. Shelly
The Broken Earth  - NK Jemisin
Oryx and Crake - Margaret Attwood
The Ministry for the Future - Kim Stanley Robinson
Olga Dies Dreaming - Xóchitl González
Land of Milk and Honey - C Pam Zhang
Day of the Triffids - John Wyndham
 
Links
The BMJ’s annual climate issue
Cli-Fi—helping us manage a crisis
Writing towards a healthier future amid climate disaster
WISH report - Tuberculosis
 
Lakshmi’s references
Fundamental Role of Arts and Humanities in Medical Education 
Capable of being in uncertainties’: applied medical humanities in undergraduate medical education
The introduction of medical humanities in the undergraduate curriculum of Greek medical schools: challenge and necessity
The medical humanities at United States medical schools