Tuesday, December 30, 2008

Merry Christmas?

No I didn't forget it was last week. I wanted to point out there is a tradition of jollity in the world of medical news that is in danger of being fractured by the advent of e-publishing.

The way it worked was this. The press releases for each week's British Medical Journal and Lancet would be issued, embargoed, for publication every Friday. It meant that both eminent journals released their Christmas issues the Friday before Christmas - and the Christmas issue was traditionally pretty wacky.

Over the last year the embargoed Friday press releases have all but ceased. Articles are published on the internet first. Embargoes are enforced but they can be any day of the week.

This year's Christmas British Medical Journal stories were released on Thursday 18th and they were certainly a crazy mixture. We headed the story Head-bangers, texting, Twist and Slam.There was a second one about common medical myths. It is true that some of the reports contain a germ of seriousness - but it was interesting that so far ahead of Christmas a number of reporters seemed to report some of these items with po-faced seriousness.

And of course the Lancet did not come out the same day. In fact it does not seem to have had a comparable collection of stories - although a series of reports trickled out. There was the one about the woman who fainted after eating sandwiches. And another one about sneezing emerged so late that we did not bother to report it.

Saturday, November 29, 2008

A dose of our own medicine

A report this week struck right at the heart of what we do. Yes. it was another analysis of the world's medical journalism.

There was a conflict of interest but we did not hold back. We reported the story.

Like most such analyses, it concluded that most medical journalism in the mainstream media is flawed. That's no surprise. But the study, from Alberta, Canada, did make some interesting points.

It suggests four kinds of basic information that should be included:
  • the number of patients;
  • the methods used;
  • the doseage;
  • conflicts of interest.

Tania Bubela, who conducted the research, seemed to want to make the case that reporting is biased against alternative therapy. So I think that was why dose was important in her mind - as it is less standard in, say, herbal medicine than in mainstream.

Methods is an interesting challenge. Yes we always try and report the methods used. Frankly its tedious for the writer and the reader. The problem is that the "gold standard" is the randomised control trial. This means that neither the doctor nor the patient knows whether they are receiving the real pill or a fake - known as a placebo. As we saw in the case of acupuncture, creating a placebo can be problematic. It's okay with pills but with other therapies, how do you fake them?

There are other statistical methods, mainly involving the analysis of populations. These will tend to tell you about the impact of diet and lifestyle. They are rarely conclusive on their own but taken together, over the years, they can be pretty convincing. It was that kind of analysis that proved that smoking causes lung cancer - it took a long time.

And that's where numbers come into it. Yes, we would always report the number of people in a trial. It's very important. If percentage differences between a treatment working and not working are close, you want to see large numbers - thousands. If they are overwhelming smaller numbers, say hundreds, will do. The trouble is we still live in a world where some people have done statistics (and hence standard deviation etc) at school and others have not. Increasingly the younger generation, certainly in Britain, will have at least a smattering of statistics.

Finally there's conficts of interest. I touched on this in a recent posting. Frankly it's not always easy to know. But yes there are some stories which are disseminated actively by commercial interests. We are more cautious of these than others, perhaps. And we see sourcing as important. If we report a therapy, the report will generally come from a journal or a conference, possibly via a university. We will identify that source in detail. That's not usual in the mainstream media.

Saturday, November 15, 2008

Is acupuncture harmful?

There's a curious story we've written which may appear on this site quite soon. It is about acupuncture and reports a Chinese study of the impact of acupuncture on fertility treatment.

The researchers in Hong Kong set out to be scientific in their research and used standard medical research techniques. And that causes the problem.

The research compared fake acupuncture with real acupuncture. In fake acupuncture, treatment is given with fake needles which retract when pressed against the skin. This was meant to be the same as the use of a placebo in drugs trial. A placebo is a dummy pill meant to make the patient think they might be receiving treatment. So the psychological impact of receiving treatment is taken into account.

So if a drug works, patients taking the real drug fare better than those taking the placebo. If a drug is harmful, patients fare worse on the real thing. And if a drug is totally ineffective, both placebo and drug are about the same.

What Dr Ernest Ng and his colleagues concluded was that women who received fake acupuncture were more likely to get pregnant than those receiving the real thing. The women were received IVF treatment and 55 per cent of those in the first group were successful - compared with 45 per cent of those getting fake acupuncture.

What can be concluded from this? Almost certainly that acupuncture for fertility treatment does not work. But does fake acupuncture work? And is real acupuncture actually harmful, as you might conclude?

And how on earth do you write the story?

It would be a great deal easier if acupuncture had been compared with nothing. You could then conclude that acupuncture wasm harmful. But it is also possible that fake treatment is beneficial. It involved applying gentle pressure to acupuncture points - and maybe that is better than inserting a needle when a woman is trying to get pregnant.

It's been said that journalism is the first draft of history. Our story reads:
Pretend acupuncture may help boost fertility - and is better than the real thing, according to new findings.
That was not our first draft and it is just about tenable. The researchers certainly believed that the placebo effect was genuine - that fake treatment had helped to stimulate the women in some way.

It's also possible that real acupuncture was harmful to these women.

And it is even possible the whole thing is a statistical freak. The research involved just 370 women - and that is not a great deal when you are seeking a statistically robust result.

Monday, November 10, 2008

An advertising policy

If you go to our page on services and policies, you will find our policy on accepting advertising is "currently under review". It's said that for ten years - as that has been the case for ten years. The Englemed site became largely a showcase for potential clients and we drifted away from our original idea of providing a news site for the public.

Now that's changed following a major revamp. And, after some consideration and research, we even have an advertising policy - which you can see reflected on the site!

We hope the site is now more useable and that it contains useful information.

The problem we had with advertising was not to compromise the independence of our news service. We are almost unique in that we do not draw from the main news agency sources that feed all media, papers, TV and web - mainly Reuters and the Press Association. You can see that today in our very different take on the story about statins and heart disease.

If we provide a service to another website there's a good chance they may be taking pharmaceutical sponsorship or relying on selling health products. When we agree a contract we negotiate carefully so they can reassure their users the news service is unbiassed. When there's been pharmaceutical sponsorship our experience has varied - but at the very least it tends to mean some restriction on what is published. One approach is simply to agree not to report about any marketed drugs. It means the news is about other issues, lifestyle, causes etc. That's fine - but we get unhappy if we come under constant pressure to identify, say, a particular cause when there may not be medical consensus about it.

On this site we think you need to be sure we won't hold back from reporting good or bad news about a treatment. So we don't want to be reliant on pharmaceutical sponsorship - even if it were possible (and there are legal issues involved too). Nor do we want to promote herbal remedies, vitamins, dietary supplements or alternative therapies. The news about these treatments tends to be mixed and you need to be sure you are getting it fairly. They may crop up on google ads which appear on blogs. That's fine - their appearance is largely out of our control although we can and will block a repeat advertiser who is clearly disreputable.

We have for some time promoted a limited range of books from reputable organisations and authors. And thanks to the wonders of affiliate schemes, we can now promote other relevant material to our visitors. We've always had a strong family focus. This is a feature we did on pregnancy issues some time ago. And our redesign gives fresh emphasis to this.

So if you're having a baby, there's maternity wear. There's toddler and baby safety devices. And there are those hard to find gifts for all the family and special occasions. There's even a garden centre! We think this is the right kind of ethical advertising for this site - so readers can be assured they are getting real news!

Tuesday, October 21, 2008

In praise of newspapers

I worked on newspapers for nearly two decades before seeing the potential of the internet and becoming one of the first full-time on-line journalists.

It's ironic that in Britain the BBC should have become the main on-line news player. We can't pretend they are not - they dominate. For it is newspaper values, not broadcasting values that dominate web-publishing.

Consider what newspapers did:

They offered readers an instant selection of news, a kind of visual menu. It's not just the cramming of stories onto pages, it is the use of headlines. Over decades sub-editors perfected the art of writing short, snappy, intriguing headlines that caught the reader's eye and led them to that particular article. The art of the sub was refined by the constraints of the page. The sub was only allowed so many letters per headline - and often not many.

Newswriting was the same. The first sentence, the intro, has to sum up the whole story. It also has to be snappy and interesting. In a tabloid, it's more snappy, in a broadsheet it contains more detail. But the reader has to be able to take it in at a glance.

The same techniques are applied to the whole story.

Then the newspaper as a whole and each page is laid out with the same intent. The main headline, the big one in large print, is designed to be spotted by the casual browser passing by a newsagent or a newstand.

It's just the same as the web. Your readers are passing by. You have to catch their attention with a headline, with an intro. You have a fraction of a second to do so. The headline must be different and interesting. The first few words of the story must tell them it's interesting.

These are techniques and crafts that were built up over a century. If you worked on newspapers they were hammered into you.

That's why we prize newspaper experience at Englemed. We like good writing and good headlines. I always believed that newspapers, not the TV or radio, provided the template for the web. I was never sure they would adapt well - and the jury is still out on that. Many are struggling. Yet while the BBC, backed by licence fee cash, may dominate, it's had to learn newspaper ways and probably recruit newspaper journalists.

Monday, October 6, 2008

Englemed writer wins award

Congratulations to our Australian correspondent Leigh Parry who has won a major award in her home country for her writing.

Leigh's work in medical journalism came to the attention of the judges through her feature articles in a local magazine, the Medical Observer.

Here are the full details of her success:

Awards recognise outstanding contribution to medical journalism
Leigh Parry and Helen Signy recognised with RACGP Media Awards
 2 OCTOBER 2008 - The Royal Australian College of General Practitioner (RACGP) is presenting two awards tonight recognising contributions to Australian medical journalism.

Dr Vasantha Preetham, outgoing RACGP President, will be presenting the awards tonight at the Academic Session of the Wonca Asia Pacific Regional Conference/RACGP Annual Scientific Convention 2008 in Melbourne.

The awards recognise the excellent work of medical journalists in the areas of general practice news journalism and general practice clinical journalism.

“The media plays an important role in communicating key health care messages to the public. This means that journalists have a critical role in ensuring their reports are accurate, balanced and responsible,” said Dr Preetham.

“The RACGP is a champion of quality and excellence in general practice, so it is no surprise that we have extended this to health journalism! Congratulations to Leigh and Helen,” said Dr Preetham.

The winners for 2008 are:

RACGP Award for General Practice Clinical Journalism
2008 Winner: Leigh Parry (Medical Observer)
This award recognises the medical journalist whose work displays the specialist skills required for accurate reporting of clinical medical issues and whose work has had a significant impact on Australian general practice over the past year. The winner’s work has been judged as having consistently met high standards through appropriate research, balanced reporting and demonstrating respect for their audience, and whose work has supported high standards of general practice care for the people of Australia. In particular, Leigh is being recognised for her Medical Observer feature stories, which are balanced and well researched.

Monday, September 29, 2008

Drugs or lifestyle - which is Britain serious about?

I find the comments made for World Heart Day yesterday quite disturbing. The European Society of Cardiology is concerned that health services are failing to take simple steps to reduce the risk of heart disease.

In other words, across Europe doctors and community nurses are failing to give basic but firm advice to patients - that they are too heavy, they should not smoke and they should improve their diet and take more exercise.

"The vast majority of high risk patients in Europe are not provided with a professional lifestyle and risk factor management programme," according to Professor David Wood.

It will be interesting to see how British doctors react to the statements. for there has been an increase emphasis in modern general practice, backed by contractual incentives, on preventing disease. If you smoke, you will certainly be encouraged to give up. If you visit your doctor, you are likely to have your blood pressure taken.

But then what?

As someone with relatives with high blood pressure I perceive a problem. For the Americans several years ago established that good diet and low salt levels can be almost as effective as drugs as reducing blood pressure. This was a massive study called DASH.

So should not every patient with high blood pressure be referred to a dietician? In my experience this does not happen. And just in case, I checked the latest guidelines from the National Institute for Health and Clinical Excellence. It turns out they are purely "pharmacological". All about drugs. There is no requirement to do anything about diet - so little gets done. Here's the link.

You won't get the same official guidance in the USA. There the National Heart Lung and Blood actively promotes the DASH diet. Here's the link. It even includes recipes.

You can sense the frustration in the European Society of Cardiology. They have done similar studies and yet governments are not rushing to take up their guidelines. In Britain it is the same government that complains frequently and bitterly about the rising cost of prescriptions. Why?

It also tells people to lose weight and urges "five a day". Yet the system fails to link this well-meaning advice directly to the diseases that people suffer and the drugs they are required to take. Is this a result of our paternalistic health system or just a conspiracy? Is it just a shortage of dieticians? Or am I wrong?!!

Here's the link to the latest Euro-heart guidelines, which set out not just what patients should do but what professionals should do.

Thursday, September 11, 2008

The Mediterranean diet - again

Another big story on the so-called Mediterranean diet today. This time researchers say it seems to help protect against chronic diseases.

The latest research picks up Parkinson's disease and Alzheimer's disease as well as heart disease and cancer. That makes it interesting so this time we are reporting it.

But as in May, I still have a problem with the medical definition of a Mediterranean diet. "Rich in olive oil, grains, fruits, nuts, vegetables, and fish", yes. But low in alcohol? Whatever happened to the grape and the wine that appears on dinner tables throughout the continent. The only really distinctive feature of the diet described here is olive oil, which by all accounts is pretty healthy. But nothing about the juice of the grape?

Again the latest findings ought to have credibility as they emanate from Florence, Italy. Florentines should know!

Sunday, September 7, 2008


Just a reminder of what we can do for your website. For a decade we have provided very specialised news feeds for a number of medical and health websites. When you sign up you deal directly with the editorial team and we can discuss exactly what kind of news and what frequency you want.

We can also support much broader newsfeeds, as with our collaboration with Doctors.net.uk. Although the web may seem to offer dozens of free health newsfeeds most originate with two or free major providers. Ours our distinctive, written knowing who are customers are. We've always been keen on sourcing and encouraged by the medical community we can provide quite detailed sources for material. This is important on the web and most major news organisations don't do this. Sometimes you can read a report and it's quite difficult to identify the quality of the research you are reading about.

Topics we have covered over the years include hepatitis C, haematology, allergy, oncology, technology, psychiatry, gastroenterology.

If you want to chat about this get in touch through newsroom (at) englemed.co.uk

Saturday, September 6, 2008

A tenth anniversary

Congratulations to our long-standing partner Doctors.net.uk now celebrating its tenth anniversary with a splash of balloons.

We're a little older and celebrated our tenth last year.

Friday, August 8, 2008

That was Web1 that Was

One more blast from the past by way of introducing a discussion on the future of news on the web.

This was a series we did on hormone replacement therapy over a period of five years from 1997 to 2002. At the beginning of the period the first reports of side effects of this treatment were emerging. By the end, doctors were ceasing to prescribe it as a routine treatment.

For two years from 2000 to 2002, we backed this up with a discussion page. It was all done by hand. At the time you could not use an off-the-shelf discussion forum, let alone set up a blog. Comments were posted and laboriously added to the page by hand. This was a subject that has affected many women and comments continued to come in years after we ceased to maintain this micro-site in 2002 when the issue was all but settled.

Here's a flavour of the comments that came in later:
2004: Sylvia: "I took hrt for 19 years and felt good. I thought that I would try a period without it. I am 65. I came off it for two years and felt depressed,
very low, extremely tearful and lost my 'get up and go'. I am now back on it and I feel really great again. I intend to always take it."

2004: Diane: "I had a hysterectomy (including my ovaries) approximately six years ago. I have been on hrt for all of this time but unfortunately cannot say
that I feel good. I no longer feel like a woman. I feel that I have lost my looks, my hair has lost its shine and my skin looks really dull and I feel
lethargic all the time. Does anybody have any advice they can offer me in how I can feel better and feel better about myself. "

2003: Lynsey: "I take climagest 2mg I am 44 and I now feel very worried what to do. Either to stop or continue I have been taking HRT for 12 months."

Des: "My mother has recently recoverd from breast cancer, she used HRT for a few years. I am very concerned that she was never told the dangers of taking these drugs, although they did make her feel better the risks long term could have been, and still could be life threatening. I would also like to know if there is anything being done to help these people who like my mother have suffered possibly unecessarily."

Charlotte: "I had a hysterectomy at age 24 have been on hrt since that time, I am now 45. Found a lump in my breast 6 months ago, so far it's nothing. I am going to quit the hormones, and am wondering if coming off slow is better then just stopping."

People like to talk about their health and there's quite a few discussion forums around the web where they do that. They also like to check out information and rumours. If a report is in the newspapers they like to know what substance there is to it.

We felt at the time that by compiling a series of reports over a significant length of time, we gave readers a chance to get a flavour of how a medical debate was panning out. It was the same with the question about oils and fats in the previous posting. Individual reports may say something unexpected but when they saw the whole saga, reasonably intelligent reader would reach a single conclusion.

Now you can do this by means of a search engine....except that it will return an awful lot of results and building up the story is not always at all easy.

Next I want to take a look at the NHS Choices website. The British government plans to spend a whopping £80 million on this over the next three years. It has some interesting ideas ... but can it really become the ultimate consumer health site?

Thursday, August 7, 2008

Human engine oil!

Our fellow blogger, Reluctant Allergy Sufferer, has recently switched to a fish only diet. You have to read RAS's blog to understand the reasons!

There seems to be plenty of cheerful news for RAS in recent news stories. This is a subject that Englemed took an interest in from the start - and in some ways the flow of scientific stories about healthy eating seems to have slowed down in the last decade. That may be because the matter was largely settled - and our conclusion at the time was that the healthiest oil was olive oil, the key component of the so-called Mediterranean diet. As we reported recently here, this particular diet continues to attract interest. There is not universal agreement about what's in it but olive oil is definitely an ingredient.

RAS can't eat olive oil and uses rapeseed oil instead - that may well be just as healthy.

One story this week suggests that fish-eating helps maintain the health of the brain.Interestingly this finding does not apply to fried fish, such as traditional British fish and chips. I wonder whether this might depend on how the fish is fried. Traditionally it would be fried in animal fat and the chances are that modern shops use sunflower oil, which is not the healthiest of vegetable oils.

A second report last week looked at the Japanese lifestyle, which is based on fish. The Journal of the American College of Cardiology doesn't put a number on the benefit but instead reports on studies of Japanese men which suggest their arteries are in incredibly good shape.

Here's a link to our original feature, entitled Human Engine Oil, which dates from as long ago as 1998 in the very early days of the world wide web. The overall conclusions probably have not changed much in a decade although some of the paradoxical individual stories would seem to hold little water. For instance the theory that meat was better at preventing stroke than vegetable oil needs to be treated with utmost caution.

The way scientists talk about oils and fats has changed however. There's more emphasis on the difference between omega-3 and omega-6 and less on the concepts of polyunsaturated, saturated and monounsaturated.

Saturday, July 12, 2008

Grammes and pounds

Although metric weights and measures have been used in science for donkey's years, they continue to pose problems for the writing of English. Habits may be slowly changing in the face of official intransigence, but English families do expect to be told the weight of a baby in pounds and ounces and to measure the height of their children in feet and inches.

It's a particular problem when you are dealing with obesity because the concept of body mass index is based on the weight, in kilogrammes, divided by the height, in metres squared. That's very hard to calculate when your original information is based on imperial measures.

This is a roundabout way of confessing I was caught out late one night last week. I don't like admitting this because we pride ourselves on our numeracy, our ability to make sense of percentages, probabilities, weights and measures etc. I will tell how it happened and to make sure it does not happen again have placed a metric to imperial converter on the left hand column of this blog.

Quite late I realised that a good story on the survival of frozen embryos had not been written. The press release informed me - or so I thought - that these babies weighed on average about 200g. I reckon to be able to do this calculation in my head. One kg is 2.2 lbs. 200g is one fifth of this - and out the other end came seven pounds. Why? Well like every good primary school child I was using estimation. The report told us that these babies were quite healthy - which to my mind means between 2lb and 12lb. So our initial reports states that the babies weighed about 200g - or seven pounds.

In the cold light of day somebody pointed out the mistake and we set out to correct it. For 200g is more like six ounces - but that seemed incredible. Far too small for a new-born baby to survive.

So back to the original press release and this is what is said: birth weight was also higher – about 200 grams – in the FER group.

What it means to say was: birth weight was also higher – by about 200 grams – in the FER group.

So I can lay some of the blame at the European Society of Human Reproduction and Embryology, which put this out. I'll also double-check the conversions on the calculator. But the journalistic lesson is, as always, if you don't trust something, don't print it.

And here's a link to a US government site which allows you to compute BMI from imperial measurements (feet, inches, stones and pounds)

Tuesday, July 1, 2008

The poly-gone that didn't bark in the night

Pity us poor journos. What are we to do when the Darzi report on the future of the NHS appears to offer none of the controversy we were promised?

Most noticeably - and I have checked - it does not mention the word "polyclinic" once.

It ought to be a gift for headline writers.

For a start there's the polly that didn't bark in the night. ( A reference to a Sherlock Holmes story for the unlearned)

Then there's the old joke about "polly gone" or in this case "poly gone" - clearly a story with many sides.

But most of all you long to do something with that Monty Python sketch. Is it a "dead polly" or a polly that's no more? And of course all these headlines don't really make sense. So today we've settled for "poly-plan gone" and "Is poly-plan no more?". I wonder if anybody else will do better.

Then there's the question of the content of the report. Even yesterday morning the papers were warning of outrage as general practice was handed over to private, nurse-run companies.

The report was published - with apparently none of that. Or is it buried in there somewhere?

Now reports of this kind are notorious for this kind of misinformation. Expectations and alarms are raised and then damped - everyone breathes a sigh of relief and welcomes all the good intentions. And there do appear to be many interesting ideas in this report.

Or has the Royal College of Nursing appeared to have spotted what the BMA and the Royal College of GPs missed. This was a modest proposal to allow nurses to transfer to the private sector by taking their NHS pensions with them. Welcome news to the RCN but not necessarily GPs. So is that the real meat (sorry, the parrot) of the report?

Friday, May 30, 2008

What exactly is a Mediterranean diet?

Here's one we didn't do today. Normally a story about the so-called Mediterranean diet is a must for any newsroom.

It's the perfect storm. A diet redolent of lazy holidays overlooked by olive groves, of salads and exotic moussaka or pavlava or squid, and all topped off by excellent cheap wine. And it is really, really good for you, little doubt about that.

Today's story in the British Medical Journal purports to link the Mediterranean diet to a reduced risk of developing type 2 diabetes - that is the type of diabetes usually contracted later in life and caused by overeating and being overweight.

It originates from the Mediterranean country of Spain, home of olives and paella and on the coast of excellent sea-food.

There's only one problem with the story - the definition of the Mediterranean diet. Rich in olive oil, fruits, nuts, vegetables and fish, yes. But low in meat and alcohol?

Certainly not low in alcohol and when you think of moussaka or a traditional Italian meal you must question whether southern Europeans are really that averse to meat. Not when a standard meal consists of a pasta course - topped off with a meat sauce - followed by a meat course.

Yes, it's a healthy diet, I'm just not sure it's a Mediterranean diet, not without copious quantities of wine.

Thursday, May 8, 2008

Embargoes in danger

How long can the system of embargoed media stories survive the internet?

My question is provoked by the publication of the Commons health select committee's report on last year's junior doctor training fiasco. As expected the report did not spare individuals or organisation in its robust condemnation of what happened.

The report was embargoed until one minute past midnight today and we went to some lengths to get reports ready for publication on Doctors.net.uk at the crack of midnight.

Why did we bother waiting up? At 11.30pm on Wednesday a link to the report was posted on a DNUK discussion forum. That meant the committee had broken its own embargo - because of course it would rely on IT technicians to ensure the full report popped up at the correct time.

No matter because the on-line version of The Times carried the story at 9pm on the Wednesday, breaking the embargo with three hours to spare.

This is now a regular occurrence. Embargoes are particularly important in medical journalism because details of most medical journals are released in advance of publication of the journal. The Lancet and the British Medical Journal appear at one minute past midnight every Friday for instance. Except that the embargoes are routinely broken, without punishment, by on-line versions of the newspapers which appear on the web before midnight.

The newspapers should take care as it is embargoes that help them give their print editions an appearance of being fresh. You can release a story at 5pm and the chances are it will not make it into print the next day unless it is a major breaking story. It would be no problem for our service nor for many bloggers. The broadcast media might not be happy because they like time to compile interviews.

Having come from the world of newspapers we understand embargoes and observe them. It is to our advantage to do so - yet we would also benefit from fewer of them. We frequently report interesting health stories before they filter into the mainstream media!

Thursday, March 6, 2008

Hard to avoid a comment

Hard to avoid a comment on today's medical news feed.

A new poll, commissioned by the Royal College of Physicians, finds that yet again doctors are the most trusted professionals in the public eyes.

A doctor rates as trustworthy to 90 per cent of people, a professor to 78 per cent and a government minister to 20 per cent.

Then up pops Ara Darzi, who is a lord, a professor and a government minister. He is also a pioneer in surgical robotics and yesterday was opening a new robotics centre at Imperial College.

So what would be his personal rating? Or does it depend whether you are his patient, his student or a member of the public. I suspect so.

Thursday, February 14, 2008

GPs speak out

Here's a great YouTube posting from two GPs, seeking to explain the current conflict between their profession and the government. It's done in the hard guy, soft guy format of the kind used by comics Mitchell and Webb: