Archive for 2012

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Dec 31, 2012

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humour, medicine

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There is a paper in Academic Medicine entitled ‘Can Medical Students Afford to Choose Primary Care? An Economic Analysis of Physician Education Debt Repayment’ (DOI: 10.1097/ACM.0b013e318277a7df). The background being that primary care salaries in the US are below those of specialists. In the UK, as far as I can see, the salary differentials are reversed. […]

Dec 20, 2012

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research

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There is a cogent piece in Nature attacking many claims about how much money should be spent on scientific research. I do not think there is anything stikingly new about the arguments, but it is unusual for the mainstream science literature to give them much space. David Golston writes: The first problem is that some of […]

“The core explanation is this: the academy lacks a serious culture of teaching and learning. ” From an essay by Richard Keeling and Richard Hersh in Inside Higher Ed. No punches pulled, and hard to disagree with. Indeed the problem in what they say is that we know it already (puts me in mind of […]

Dec 05, 2012

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medicine

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There is an interesting article from Randall and Downie in Clinical Medicine (December 2012— I cannot see it online yet). The issue is about consent for transplantation, and my interest and knowledge is as a lay person, rather than an expert in this area. The gist of  the article is that statements about ‘donation’ made […]

David Healy’s Pharmageddon is reviewed in Health Affairs. It is a must read if you are interesting in medical care and the role of Pharma. The review by Donald Light  is very favourable: “In my view, Healy’s book is the most powerful and deeply thought of a new crop of books on pharmaceuticals and medicine”. […]

Nov 26, 2012

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medicine

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John Ioannidis has been very successful in pointing out what had been  hidden in plain sight: we should assume that many— if not most— publications about therapy, including RCTs, are wrong. Here he shows his pen can muster a lovely turn of phrase. He is reviewing ‘Seeking Sickness’ by Alan Cassels in Lancet Oncology. The […]

Nov 17, 2012

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learning, quote

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Humans compute and transfer nongenetic information between generations, creating a longitudinal intelligence that is unlike anything else on Earth. The data links that hold the structure together in time swell rhythmically to the frequency of human regeneration. This is education. He writes, about his father who was a teacher: Adding to an already rich life, my […]

Nov 15, 2012

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quote

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On the usually sound principle that there is nothing in UK medicine that can’t be made worse by the involvement of the General Medical Council Nigel Hawkes in the BMJ last week.

Nov 11, 2012

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universities

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John Naughton (rightly in my view) arguing that the current online bubble will leave the ‘high status’ colleges largely alone. Hmmm… I think I’d read this as Round Two of the 1999-2000 fantasies about online education. It smacks of Fathom.com. But the movement started by Peter Norvig and Sebastian Thrunn will eventually have a disruptive […]

John Naughton in today’s Observer, commenting on the merger of Penguin and Random House. Ho, ho. In the long view of history, the Bertelsmann-Pearson deal will be seen as just the latest instalment of a long-running story: a tale of formerly dominant industries trying to prevent their venerable business models being dismantled by the internet. The […]

The title is from Rich DeMillo. I do not know whether the analogy is correct, but it is enlightening, and I like the skunkworks metaphors. In another post, Tony Bates lists some of the funding going into Ed Tech companies this year: According to the National Venture Capital Association, a staggering $463 million has already been […]

Much biomedical research bores me. All too often it is either dull risk factorology (i.e. most epidemiology) or, as for so much cell biology and biochemistry, endless chasing of one molecule causing another molecule to change and, in turn, alter yet another molecule. The cascade goes on: there are lots of molecules after all. It […]

The current management of skin cancer in the UK and many countries is based on what might be termed a ‘corner shop’ model. Patients present to their general practitioner (GP) or to a single- handed dermatologist in office practice and either (i) are diagnosed as not needing further treatment because the suspect lesion is benign, […]

Musing on markets and health care, and what happens when literally it is your own skin at risk. The man had good insurance, and he and his family used it freely to provide him with as much comfort and care as possible. I can’t imagine they’d have acted differently were they paying out of pocket. […]

Oct 13, 2012

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learning, quote

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One does not automatically enhance learning by making learning fun—by making it pleasurable. Nor does one enhance learning by making it materially rewarding (a fact amply demonstrated by the failure of recent efforts to improve student performance with often substantial material incentives). Book review in Science by Barry Schwartz of Beyond Pleasure and Pain How Motivation Works by E. Tory […]

Oct 04, 2012

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learning, quote

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Education is a double-edged sword. You have to start where people are, but if you stay there, you’re not educating. The ever insightful Alan Kay.

Oct 02, 2012

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learning

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With Donald Clark, I agree. What actually happens is that the extrovert quickly volunteers to be the chair (or becomes chair by default as no one else can be bothered), the table spends too long deciding what the ill-formed question actually means or shoots off on obscure tangents, the question forgotten. The chair then feeds […]

Oct 01, 2012

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learning

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Nicholas Carr has a really good piece on MOOCs and online learning here, and a very nice distillation of many false (technological) dawns here. Quote from the latter Phonograph: In an 1878 article on “practical uses of the phonograph,” the New York Times predicted that the phonograph would be used “in the school-room in training children to read properly […]

The world may not need more examples of stupidity or ignorance, or hatred, but examples can sometimes be illuminating and funny. I always like the tale told by Jacob Bronowski in the Ascent of Man, about how Friedrich Hegel’s thesis proved ‘philosophically’ that there could only be seven planets. The thesis was presented in 1800 […]

Sep 29, 2012

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learning

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The really good things about all the talk about MOOCs is that it means people are thinking and talking about learning. Figure from here

Sep 27, 2012

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medicine

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Global industrial output was 57 times greater in 2010 than it was in 1900. In other words, manufacturing has grown far faster than the overall economy. The main reason for this is that factories keep getting smarter in ways that hair salons do not. From a review of Peter Marsh’s new book in the Economist. […]

Sep 25, 2012

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medicine

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I wrote quite a few articles (EBM) many years ago on the inadequacies of the EBM sect and their dogmas. My take is that EBM is now slowly dying as a serious attempt to understand the natural world or clinical practice except at an institutional level. EBM remains popular with bureaucracies such as the NHS or […]

Sep 25, 2012

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medicine

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My article in the BMJ continues to attract a few letters. Worth reading them. This link should get you behind the paywall. I have had a small number of emails from GPs direct. Some clearly believe they are the only people who do any work in the UK and, not surprisingly, they reserve their scorn […]

Sep 20, 2012

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medicine

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GSK is a recidivist. How can a company commit a $1 billion crime and no individual is held responsible? ………On July 2, 2012, the Department of Justice announced the largest settlement ever in a case of health care fraud in the United States. GlaxoSmithKline (GSK) agreed to plead guilty to three criminal counts and settle […]

One of the most telling metaphors about competence I know  comes from Frank Davidoff: Competence, in contrast, is like “dark matter” in astronomy: although it makes up most of the universe of working knowledge, we understand relatively little about it. What does it really consist of? Which of its components are most important? How do […]

Sep 04, 2012

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learning, medicine

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I enjoy Roger Schank’s blog and writing. This is not meant to be followed by the caveat that his views are a little extreme. They are, but that just reflects that most people are wrong. A recent post is a lovely summary of  what real education is about. What shocks me is how well his […]

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