Medicine and Science from The BMJ

In this episode, we hear how Generative AI is making it into the consultation room - but not through NHS endorsed routes - surveys suggest that ⅔ of doctors are using AI, for backoffice tasks - but also increasingly for information and diagnosis.   David Navarro, a research fellow in generative AI at the Australian Institute of Health Innovation, Charlotte Blease, associate professor at the Participatory eHealth and Health Data Research Group at Uppsala University, and Marcus Lewis, GP in London, reflect on what we know about the real way in gen AI is being used - and what “triadic care” (doctor, patient and AI) will mean for the future of the therapeutic relationship.   We also hear from Teppo Järvinen, professor of orthopaedic surgery at Helsinki University, about surgical subacromial decompression - a 10 year follow up of a double blinded placebo controlled trial, confirms that surgery is no more effective than standard care. Yet surgical interventions continue - we hear why.   Finally, we go to a Cholera clinic in Nigeria, where Médecins Sans Frontières are running cholera treatment centres, which you can help by donating to our Christmas appeal.   Links Generative AI and the clinical encounter   The BMJ appeal 2025-26: Inside MSF’s response to cholera in Nigeria: a day in the life of an emergency doctor   Arthroscopic subacromial decompression versus placebo surgery for subacromial pain syndrome

There is an enormous amount of research on treatment for ADHD - pharmaceutical and otherwise. But not all of those trials, or meta-analyses, are of high quality; and not many compare the whole literature.  Now a new umbrella review - a review of reviews - tries to give a broad overview of the whole evidence base. Corentin Gosling, associate professor at the Université Paris Nanterre, joins us to set out the benefits and harms of ADHD therapies.   Also, the BMJ’s been investigating the employment of doctors on “local” contracts in the NHS - and our latest look at this exposes what some have described as a “gig economy”, with doctors plugging rota gaps but missing out on training, development, and salary progression. Rebecca Coombes, head of journalism at The BMJ explains more.   Finally, Tom Frieden is former head of the US Centers for Disease Control, and current CEO of Resolve to Save Lives - he’s written a new book on public health. He joins us to talk about what actually improves health at a population level, and why the current US administration’s approach to staffing the CDC is leaving the country open to danger.   Reading list Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making Revealed: Thousands of NHS doctors are trapped in insecure “gig economy” contracts  

  "Damning” and “unforgivable failures” is how some papers headlines reacted to criticism of former UK prime minister Boris Johnson in the second of 10 reports from the UK Covid Inquiry. Under pressure, in 2001 Boris Johnson announced a covid inquiry led by a former judge, Baroness Hallett. Each report is examining a different area of the pandemic's impact, and module 2 is about decision making and political governance. The report describes inertia, toxic cultures, and an inability to learn lessons - disfunction that contributed to many extra deaths.  To dissect the report and discuss what needs to change, we're joined by; Rebecca Coombes - The BMJ’s head of journalism Kevin Fong - anaesthetist and lead for major incident planning at University College Hospital Matthew Flinders - Professor of Politics and Public Policy at the University of Sheffield  

It’s the BMJ’s annual climate issue - and in this episode, we’ll be hearing about more ways in which climate mitigation is good for health.   Firstly, climate change is fuelling conflict, and exacerbating the impact it has on fragile healthcare systems. Andy Haines, from the London School of Hygiene and Tropical Medicine, and Barbora Sedova, from Potsdam Institute for Climate Impact Research, discuss how climate and conflict intersect, and what they think needs to be done to combat it.   “Car spreading”, the recent tendency for cars to become bigger and heavier is not only harming the climate, but it’s also harming pedestrians.  Anthony Laverty, associate professor of public health at Imperial College London, and trauma surgeon Cleo Kenington explain why SUVs are more lethal in accidents, and why France is bucking the trend in sales.   Finally, Jocalyn Clark, the BMJ’s international editor joins us to talk about women’s health innovation and why tech bros aren’t the people to be leading it.   Reading list:   The climate issue: Brazil and the climate crisis   Tackling the complex links between climate change, conflict, and health   Reducing the harms from ever larger cars   Transforming women’s health through innovation

Far right rallies have been held across the UK, culminating in a large parade in London where Elon Musk spoke. At the same time, politicians from across the political spectrum are following the talking points of far right parties - and shifting their policies rightward, even the Labour home secretary has said she wishes to double the period migrants have to be in the UK before they can become citizens. That has made a group of medics decide it’s time for doctors and other healthcare professionals to use their voice and speak up - against the demonisation of migrants into the UK, and for their fellow NHS staff. They are demanding that those in positions of power do so too.   Some of those medics join us on the podcast today; Alistair Stewart, consultant psychiatrist in Manchester  Omnya Ahmed, resident doctor in London  Jordan Rivera, occupational therapist in London   Also this week, doctor, researcher, comedian and Matt Hutchinson is adding author to his list, and has released the book “Are You Really the Doctor? My Life as a Black Doctor in the NHS” - he joins Shivali Fulchand to talk about balancing all of this bits of his career - and how standup comedy has helped him maintain his career in the NHS.   Reading list Everybody’s business: call to all NHS staff to oppose the influence of racism and the far right

This week on the podcast The BMJ investigates Q-COLLAR, an American device that distributors claim can reduce brain injury from contact sports. Investigators James Smoliga and Mu Yang take us through the evidence, and former NFL punter turned US bobsled team member Johnny Townsend explains what this means for sportspeople. Bin Wang from Zhejiang University School of Medicine explains what the new network metaanalysis finds is the best exercise options for knee osteoarthritis And, what our patient panel really think about “patient choice”.   links How an FDA cleared “brain protection” device built on shaky science made it to the NFL Comparative efficacy and safety of exercise modalities in knee osteoarthritis The BMJ's patient and public partnership

In this episode of the podcast; In July this year, the Government published their 10 year health plan for England - A new analysis just published on BMJ.com takes an in depth look at the chances of that plan succeeding, and where the government needs to focus time and resources. Bob Klaber, paediatrician and director of strategy, research and innovation at Imperial College Healthcare, and Helen Salisbury, GP and columnist for the BMJ join us to discuss. Journalist Chris Stoker-Walker's grandfather suffered from delirium at the end of his life, but the journey to that diagnosis was difficult - Chris joins us to talk about the impact that had on his family, and Elizabeth Sampson, professor of liaison psychiatry from Queen Mary University of London, explains why it's under-researched. Finally, we've been reporting from Gaza for 2 years, and it's been very difficult to get accurate information out of the region. However, new research published on bmj.com has surveyed medics there, to document the patterns of wounding in the civilian population - to improve the medical response to the conflict. Omar El-Taji and Ameer Ali, resident doctors in the NHS join us to explain what they found.   Reading list: Delivering on the 10 year health plan for England Why can’t we do anything about delirium? Patterns of war related trauma in Gaza during armed conflict  

In today’s episode: Assisted Dying moves closer to becoming UK law. The proposed legislation to allow people to end their own lives has moved through a second debate in the House of Lords. What do MPs and doctors think of the Bill as it stands? And, new ways to pull research findings from observation alone makes us question whether correlation really doesn’t equal causation. We find out - what is Target Trial Emulation? The BMJ’s Elisabeth Mahase speaks to Labour MP Kim Leadbeater, sponsor of the Assisted Dying Bill. Why did she propose the legislation? What has been her impression of its movement through Parliament and the opposition it has faced? We also hear from Jamilla Hussain and Gareth Owen, doctors who attended a BMJ parliamentary roundtable on the topic. Finally, the BMJ’s Duncan Jarvies talks to our research editors about new ways to develop evidence from observational studies. What are the limits to this new technique of causal inference? Reading list MP behind assisted dying bill warns that terminally ill people and their families are being failed, ahead of Lords debate Assisted dying bill: Lords debate concerns over lack of safeguards Transparent reporting of observational studies emulating a target trial: the TARGET Statement

In today’s episode: Rethinking how we measure the harm caused by the  arms industry The life long, and multigenerational, impact of starvation in Gaza What is the appropriate focus on prevention in general practice?   The BMJ's international editor, Jocalyn Clark talks about a new series we've just published - examining the arms industry as a commercial determinant of health. Jocalyn also speaks to Mark Bellis, from Liverpool John Moores university about why he thinks it’s time we take the impact of the arms industry on health seriously. The blockade on food reaching Gaza is in place again, risking more starvation. Elizabeth Mahase, clinical reporter for the BMJ, has been finding out about the acute, chronic, and generational impact on the palestinian population. She speaks to Jonathan Wells, professor of anthropology and paediatric nutrition at University College London, and Tessa Roseboom, professor of early development and health at the University of Amsterdam, Marie McGrath former head of the Emergency Nutrition Network, and Chris McIntosh, humanitarian response advisor for the charity, Oxfam. Finally, an analysis we published earlier this year made the case that "tsunami" of preventative care is destabilised the work of GPs. Helen Macdonald was at the Preventing Overdiagnosis conference and spoke to some of the authors - Minna Johansson, associate professor at University of Gothenberg, Stephen Martin, professor at UMass Chan Medical School, and Iona Heath, retired GP and former president of the RCGP.   Reading list Arms industry as a commercial determinant of health Starvation is a lifelong sentence: Gaza’s civilians must be protected in accordance with international humanitarian law Sacrificing patient care for prevention: distortion of the role of general practice  

CRISPR technology has revolutionised biological research, and for the first time it’s out of the lab and into the NHS, as NICE has approved its use as cost effective. Kenneth Charles, senior lecturer in haematology at the University of the West Indies explains how the treatment works, and what concerns he has about it's implementation. Also this week, a new investigation on bmj.com has looked at a number of British companies who are offering to collect children's teeth for stem cell extraction and storage. Freelance investigative journalist Emma Wilkinson explains the "outrageous" claims she found them making. Finally - we’re finishing with the football. Team GB had a strong showing this year -  our over 25 men’s team brought the trophy home, and our womans team competed for the first time To explain more about the medical world cup we're joined by Minnan Al-Khafaji, captain of the women’s team, and Jamie Thoroughgood, captain of the men’s team.   Read more. Banking baby teeth: companies may be misleading parents with “outrageous claims” CRISPR therapy for sickle cell disease Follow the British Medical Football Team on instagram

If you’ve been in a high street pharmacy or supermarket recently, chances are you’ll have seen home test kits for all sorts of indications; blood sugar level, vitamin deficiencies, thyroid function, and even some forms of cancer. A new series of article in The BMJ revealing serious concerns with the reliability of these home tests, and raises questions about their regulation. Jonathan Deeks, professor of Biostatistics at the University of Birmingham, joins us to discuss what these tests are, and how his team have rated their usability. Also this week, the sad death of a child in Liverpool from measles highlights the growing outbreak in the UK - and this may be one of the first times many doctors have come across the infection. Frances Dutton, GP at the Small Heath Medical Practice reminds us how to recognise the sign of the infection.   Reading list Direct-to-consumer self-tests sold in the UK in 2023 How to recognise and manage measles

Professor Gillian Leng, President of the Royal Society of Medicine was asked to carry out an independent review into the role of physician and anaesthetic associates. She sits down with Kamran Abbasi, editor in chief of The BMJ, to discuss her findings. In the UK, the rollout of physician associates, NHS staff who took on some of the tasks of doctors, has been both haphazard and controversial. Originally copied from similar roles in the U.S., British PAs were introduced in the early 2000s. The level of clinical responsibility they were asked to take on began to vary around the country, driven mostly by the workforce needs of individual Trusts. The lack of clarity about their roles lead to disquiet with doctors, worry for patients, and an increasingly toxic debate on social media. 01.00 What is the Leng Review? 10:00 Recommendation one: Renaming 14:00 Recommendation two: Easier identification 16:00 Recommendation three: How to work? 20:00 Recommendation four: Diagnosis 25:00 Recommendation five: Oversight & Regulation 32:00 Prescribing and ordering ionizing radiation? 40:00 A failure of workforce planning and vision ? 49:00 The NHS 10 year plan

This week we’re focusing on the NHS. On the 3rd of July the UK’s Prime Minister, Kier Starmer finally announced the NHS’ 10 year plan. His Labour government laid out a vision for where the healthcare service should head over the next decade. The announcement has been met with mixed responses. The plan has some good ideas - but a lack of vision combined with scarcity of detail leave many questions about how well its aims can be implemented. In this podcast we're joined by 3 experts to dissect the details of this plan Jennifer Dixon is chief executive of the Health Foundation Katie Bramhall-Stainer is a working GP, and chairs the BMA’s General Practice committee. David Oliver is a consultant geriatrician, and a columnist for the BMJ Reading list News analysis: What is the NHS 10 year plan promising and how will it be delivered? Editorial: Government’s 10 year plan for the NHS in England David Oliver's column: The NHS 10 year plan—more a set of ambitions than a plan

Rebecca Coombes interviews Dr. Tom Dolphin, consultant anaesthetist and newly elected chair of the BMA Council. Watch this interview on our YouTube.    

Last December, The BMJ published an investigation into the 2009 PLATO trial - exposing serious problems with that study’s data analysis and reporting.  Our follow up investigation has shown that those data problems extend to other key supporting evidence in AstraZeneca’s initial application to regulators. Peter Doshi, senior editor in the BMJ’s Investigations unit, and Rita Redberg, cardiologist and Professor of Medicine at UCSF and former editor of JAMA Internal Medicine, join us to explain what this means for scientific integrity, and trust in the FDA's approval processes.   Also in this episode. A group of international authors are arguing that weightloss advice given in primary care might actually be doing more harm than good - it’s ineffective and potentially reinforces damaging stigma.  To explain why they came to that conclusion we're joined by Juan Franco editor in chief of BMJ EBM, and a practicing GP in Germany, and Emma Grundtvig Gram, from the Centre for General Practice at the University of Copenhagen Reading list Doubts over landmark heart drug trial: ticagrelor PLATO study Ticagrelor doubts: inaccuracies uncovered in key studies for AstraZeneca’s billion dollar drug Beyond body mass index: rethinking doctors’ advice for weight loss

In this episode, we hear about ketamine addiction. It's in the news, but the rise in addiction amongst young people in the UK has caused concern for some time.  Irene Guerrini and Nicola Kalk, both addiction psychiatrists from the National Addiction Centre, join us to explain why its become a problem. In November 2024 Wes Streeting, the UK’s health and social care minister, announced that he was planning to introduce league tables for hospitals - and would be linking managers' pay and continued employment to those outcomes.  Richard Lilford, from the University of Birmingham, Timothy Hofer, from the University of Michigan, and Ian Leistikow, an inspector at the Dutch Health and Youth Care Inspectorate, join us to explain why this is a bad idea. Non-prescribed ketamine use is rising in the UK Hospital league tables, targets, and performance incentives should be used with care

Devi Sridhar's new book  “How Not to Die  (Too Soon) - The Lies We’ve Been Sold, and the Policies That Could Save Us” is focussing on the way wellness culture ignores the societal context in which health is really created. As a trained personal trainer and professor of global public health, Devi's straddling both of those worlds, and joins us to talk about how she would tackle our lowering life expectancy. Also, John Downey, from the Centre of Health Technology at Peninsula Medical School, and Martha Lee from NHS Devon Integrated Care Board, have written about Plymouth's "Living Lab" - which has been set up to test how health tech can actually work in the real world, but also (importantly, critically) how it can be properly evaluated and integrated into the NHS and social care. Reading list How Not to Die (Too Soon) Harnessing predictive prevention to shift elderly care from hospital to community in England

Recent escalations in the ever simmering tension between India and Pakistan brought us closer to conflict - conflict between two nuclear powers. For a long time doctors have campaigned for nuclear disarmament, and Chris Zielinski, president of the World Association of Medical Editors, makes the case for returning WHO's mandate to measure the potential impact of nuclear war. Also the militarization of the region is detrimental to the health and wellbeing of the populations in both India and Pakistan. co-chairs of The BMJ's South Asia editorial board, Sanjay Nagral and Zulfiqar Butta, explain why a focus on the daily material and health needs of citizens is the way to change political rhetoric in the region. Gordon Guyatt, distinguished professor at McMaster University, was one of the people responsible for starting GRADE - which is a structured system for assessing the quality of evidence in systematic reviews and clinical practice guideline. Gordon thinks that process has become too complicated - so he’s now championing “Core GRADE”. He joins us to explain why.   Reading list Ending nuclear weapons, before they end us Why Core GRADE is needed: introduction to a new series in The BMJ

China was declared malaria free in 2021 - and we'll hear how persistence was key to their success, and what new technologies are available to help the rest of the world become malaria free, from Regina Rabinovich, director of the Malaria Elimination Initiative at the Barcelona Institute for Global Health.  Sonia Saxena, professor of primary care at Imperial College London, and Miguel O’Ryan, dean of the medical faculty of the University of Chile join Kamran to talk about what broke academic medicine, and why it's time for a revolution. New research shows that data from retracted papers is still having an alarming effect on clinical practice. Chang Xu, Hui Liu, and Fuchen Liu from the Naval Medical University in Shanghai, and Suhail Doi from Qatar University, join us to talk about their study which has maped retracted papers impact on systematic reviews and clinical guidelines.    Reading list Malaria control lessons from China Vision 2050: a revolution in academic medicine for better health for all Investigating the impact of trial retractions on the healthcare evidence ecosystem (VITALITY Study I) - An example of the BMJ's approach to updating metaanalysis after a study retraction 

The UK government is debating legislation to allow assisted dying in England and Wales, which puts doctors at the forefront of deciding if their patient will be eligible for a medically assisted death - the key criteria being a 6 month prognosis. But is making a 6 month prognosis actually clinically reliable? To discuss we're joined by a panel of experts on end of life; Scott Murray, emeritus professor of primary palliative care at the University of Edinburgh Simon Etkind, assistant professor of palliative care at the University of Cambridge Nancy Preston, professor of supportive and palliative care, Lancaster University Suzanne Ost, professor of law, Lancaster University Reading list Assisted dying and the difficulties of predicting end of life Breaching the stalemate on assisted dying: it’s time to move beyond a medicalised approach   Also in this episode, we dim the lights and raise the curtains - there is a public fascination with doctors who kill and the stage show turned podcast, ‘An Appointment with Murder’, takes a deep dive into the crimes of GPs John Bodkin-Adams and Harold Shipman. Kamran is joined by Harry Brunjes and Andrew Johns to talk medical murder. An Appointment With Murder on Apple Podcasts