1/

🧵 THREAD about probably one of the BEST discussions about social value of work, economic wealth and fairness in a while.

40 mins with @amolrajan, @PJTheEconomist @elerianm @KGerlich777 Louise Casey

@davidgraeber 🗣️ "The more your job helps others, the less you get paid"
2/

Reminded me of @euan_lawson for @BJGPjournal quoting Michael Sandel on meritocracy: bjgp.org/content/70/701…

🗣️ "In an unequal society, those who land on top want to believe their success is morally justified. In a meritocratic society, this means the winners must believe...
3/

🗣️ "...they have earned their success through their own talent and hard work.… at a time when racism and sexism are out of favor (discredited though not eliminated), credentialism is the last acceptable prejudice."
4/

@PJTheEconomist over the last 20 years:

⬇️ 30% per person spending on social care
⬆️ 100% more hospital doctors.

No extra GPs - actually the number of full time equivalents is dropping: digital.nhs.uk/data-and-infor…

And they aren't equally distributed either (inverse-care law)
5/

When we look at care work @KGerlich777 talks about care sector:

➡️ How it is heavily gendered? 80% women
➡️ How poorly it is paid and misconceptions about what it involves.

Louise Casey explaining needed huge reform and re-structure
6/

Reminded me a lot about how childcare system needed reform from @NEF: neweconomics.org/2019/11/weekly…
7/

Interesting insight @elerianm: wealth gives you resilience, opportunity and agility.

When he changed jobs for more family time, people told him

1⃣ you have to be lucky enough to change work
2⃣ they were worried about other's opinions - do we afford too much power to others?
8/

Life is not inherently fair but we do still have people who are working but are incredibly poor.

Universal credit does not cover living costs but was initially meant too.

Since 2008, income increased by 6% but wealth has increased by 18%.
9/

Solutions?

➡️ Basic income - generated from tax?
➡️ Taxation? land value tax, inheritance tax
➡️ Would a maximum wage cap be insanity?

Throw in political power it become hard to see who will back these policies as in the current climate seem unpopular.
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More from @DipeshGopal

28 Nov 20
2/

Editors' note: Dr @HDambhaMiller (Editor in Chief), Dr Umar Chaudhry (@StGeorgesUni), Dr Peter Adams (@uwicave_hill)

They explain how they will be taking on diversity/inclusion by looking at:

outreach / mentoring students
diversity at submission

bjgpopen.org/content/early/…
3a/

Our group work looks at how race and racism affects the working life of a GP: bjgpopen.org/content/early/…

When it comes to issues of race / racism, is it comfortable to ignore them?

@v_silverwood @EbMulla @olamide_dada @salmanWaqar
Read 39 tweets
26 Nov 20
THREAD on @RoySocMed ONP51: Health inequalities: what can healthcare professionals do?"

1/

Dr Chad Hockey talks about how the original game of monopoly which originally had wealth distribution that is no longer part of the game

bbc.com/worklife/artic…
2/

🗣️ "The poverty of our century is unlike that of any other. It is not...the result of natural scarcity, but of a set of priorities imposed upon the rest of the world by the rich. Consequently, the modern poor are not pitied … but written off as trash.” John Berger
3/

Healthcare provision is based on the fact that we all have the same healthcare needs but this is not the case.
Read 15 tweets
19 Nov 20
1/

From @Hludders

🔴 What are the late GI effects of radiotherapy❓

#RTLateeffects Image
2/

⚫️ How could I recognise the late effects of radiotherapy to the bowel❓

Evidence base and the screening tool: sciencedirect.com/science/articl…

#RTLateeffects Image
3/

🟠 How could I manage the GI symptoms of pelvic radiation disease❓

macmillan.org.uk/_images/practi…

#RTLateeffects Image
Read 13 tweets
13 Sep 20
1/

🧵

THREAD about why race is in the @NICEComms hypertension (blood pressure) guidelines and why it should go: nice.org.uk/guidance/ng136

@MedCrisis and I read #AngelaSaini's book "Superior" and were horrified at the inclusion of race without clear scientific basis:

#FOAMed
2/

The @NICEComms specifically implies that Black people are inherently different (assumption: biological/genetic) compared to White people.

Why? @DoctorMayJay

Suggestions: Black people are inherent salt retainers due to salt deficiency, etc: ncbi.nlm.nih.gov/pmc/articles/P…
3a/

This article from @American_Heart is a long reach arguing that there are inherent genetic differences between Black people and White people citing small genetic studies: ahajournals.org/doi/full/10.11…
Read 14 tweets
3 Sep 20
Thank you to the @bmj_latest for hosting the
#BMJCovid

@PaulGarnerWoof: #LongCovid was way long than the 2 weeks

blogs.bmj.com/bmj/2020/06/23…
@Dr2NisreenAlwan - "why aren't we measuring #LongCovid?"

#LongCovid - often has a wide range of symptoms: body ache, chest pressure, tiredness, rash. The symptoms do not completely go - relapsing and remitting. #BMJCovid

Read her article here: blogs.bmj.com/bmj/2020/07/28…
@trishgreenhalgh - "you do not necessarily need a positive test to have #LongCovid"

Let's not get too caught up with this - we weren't testing at the beginning of the pandemic. #BMJCovid

How do we manage #LongCovid. Great patient resources here: bmj.com/content/370/bm…
Read 14 tweets
26 Jul 20
🧵THREAD on Hardouin et al (2020) #MedBikini article #MedTwitter

1/

Editors' response:

Unconscious bias = implicit bias
Conscious bias = explicit, intentional

So in this is essentially misogyny and conflicts with human rights to free speech/private life. Image
2/

Methodological concerns: unspecified definition of 'controversial'. There needs to a validated definition.

🗣️ "Controversial political and religious comments were
...directed toward...faith.

Controversial social comments...on abortion and gun control."
3/

Moral concerns: clinicians performed searches on social media to conduct their research.

To be fair this is what patients could/would do. I'm not condoning this methodology.

I've had patients tell me that "I'm established" when I first met them from Googling me. 😳
Read 15 tweets

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