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Congratulations David Kuhl

Jan 27th, 2013 by Martin Dawes

David Kuhl has been awarded the Queen Elizabeth II Diamond Jubilee Medal.

He was nominated for his work in co-founding the Veteran’s Transition Program (VTP).

This is a truly remarkable acknowledgement of the work David has done for veterans and as a department we should feel very proud of his commitment and scholarship that led to the development and success of the program.

David is the Director of the Centre for Practitioner Renewal and  Professor for the Department of Family Practice, Faculty of Medicine at the University of British Columbia. Previously, he was the physician leader for palliative care at Providence Health Care for many years. As the Director of CPR, he is working to combine his interests in medicine and psychology to develop a program of service, education and research to sustain health care providers in the workplace.

 David graduated with a Masters in Health Sciences (Community Health and Epidemiology) from the University of Toronto in 1981 and received his medical degree from McMaster University in 1985. In 1996, he became a Soros Faculty Scholar, Project on Death in America. He has written two books, What Dying People Want: Practical Wisdom for the End-of-Life and Facing Death Embracing Life, Understanding What Dying People Want.

 

Congratulations – well deserved.

 

and now for something completely different ……

 

Patients with cough dont need antibiotics
 When US researchers tested a complex intervention to discourage inappropriate antibiotic prescribing for uncomplicated bronchitis, they were rewarded with a significant drop in primary care prescriptions over one winter season. Printed leaflets, posters, and algorithms seemed to work, as well as similar materials incorporated into computerised decision support. Prescriptions for antibiotics fell from 80% to 67% among patients with bronchitis in the print strategy group and from 74% to 61% in the computerised strategy group. Prescriptions went up slightly in control practices.

Could this be another effective way to change doctors’ behaviour? Not really, says a linked editorial (doi:10.1001/jamainternmed.2013.1984). Healthy people with uncomplicated bronchitis should never be given antibiotics. We have known this for 40 years and should be aiming for prescribing rates below 10%.

Efforts to change have been well made and well evaluated. We know what works, but nothing seems to work well enough. Traditional medical interventions have failed, and it may be time to look further afield to business leaders, behavioural economists, and psychologists for inspiration. We might also be clearer with patients about just what they can expect from antibiotics—a few will recover slightly faster, between 5% and 25% will have an adverse reaction, and at least one in every 1000 will present to an emergency department with a serious drug related event.

BMJ 2013;346:f254

food for thought

Martin

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