I've been writing about medical harms for over 20 years. Always hard to think that what you are doing, with very good intentions, might actually be harmful. For example, when I was a student,
we advised people with a sciatica to lie down for 6 weeks. Bed rest, people often got a wooden board to lie on. Rest the back, sounded sensible. But trials were eventually done: didn't help, caused harm journals.lww.com/spinejournal/A…
Oct 27 • 13 tweets • 3 min read
Today the first stage of the Gender Recognition (Reform) Bill comes to the Scottish parliament. Three changes are proposed. 1) removes medical/panel process for approval 2) people have to 'live in acquired gender' for 3m rather than 2y, and 3) age change from 18 to 16.
have no doubt that many people have very good intentions with this Bill and want to help people suffering from gender dysphoria. However medical history shows that good intentions often do harm, especially when we do not interrogate the evidence, and look for unintended harms.
Oct 19 • 9 tweets • 3 min read
This is a lot more complex and difficult than Charlie Massey seems to think. In the 1960s, general practice was in disarray; massive variation in quality, training, standards. See the Collings report bbc.co.uk/sounds/series/…theguardian.com/society/2022/o…
The reason why the @rcgp was set up was to ensure good quality care across UK, improve standards, training, etc…..meantime massive amounts of evidence gather that high quality GP, esp continuity, is associated with cost effective care lower mortality morbidity etc
Oct 14 • 16 tweets • 4 min read
new paper !
screening for atrial fibrillation (AF). It sounds so good, so intuitive. why not catch something early? It can cause strokes, and prophylactic medicines to cut clot+stroke risks do reduce that risk. (long thread sorry) 🧵
however: the studies that have been done up till now have shown benefit in people who are either symptomatic (have palpitations, feel unwell, etc) or are being assessed as they have another condition (eg diabetes, having BP checked);
Oct 12 • 12 tweets • 4 min read
widely reported today; the APPG on menopause.
here's the report. menopause-appg.co.uk/mps-call-on-go… you might not get from the reportage is that the report itself is researched and funded by