Harkness Fellows Blog

I’m only a couple of months into my year in the USA.

Breakfast with Lansley. Lunch with Berwick.  A chance meeting with Obama (Michelle, not Barack). And dinners with more top-rate health care academics, analysts and policy-makers from around the world than would have seemed possible just a few short weeks ago.

With this has come slides – lots of slides. Slides showing how bad things are here. Slides showing how good things are there. Slides showing how Japan is doing its best to make everyone look average, and slides showing how India plans to break the mould in eye-...

Dr Emma Stanton, Commonwealth Fund Harkness Fellow and specialist registrar at South London and Maudsley Foundation Trust, reviews Personal Health Records: a guide for clinicians by Mohammad Al-Ubaydli.

 Prior to reading Personal Health Records: a guide for clinicians I was not clear exactly what a personal health record (PHR) entailed. I suspect I am not alone. PHRs are relevant for all stakeholders in health care. If intrigued by how they are relevant for you, read on.

Although written by the...

In the Californian sun, near a beach 20 miles from the Mexican border, a man and a woman are talking:

“You don’t respect me – you can’t even look me in the eye.”

“But you just don’t understand my priorities – I need you to get to the point, to be ready for me.”

Not some US daytime soap opera, but the dialogue generated by a Kaiser Permanente away day aiming to improve communication between doctors and nurses. Using a parallel with “Men are from Mars, Women are from Venus”, the facilitator explains how nurses tend to be more interested in the quality of interactions...

Founded in 1908, the Harvard Business School is consistently ranked among the top business school rankings globally. Since 1920, one of the ways Harvard Business School has differentiated itself is by developing and pioneering the case method of teaching. For this approach, teaching is focused around cases. Each case presents a real life complex business situation, containing sizeable qualitative and quantitative evidence to enable the reader to develop analyses and arguments. This method is based on the premise that in business – including the business of health care - there is no one...

Halloween is a big deal in America. Just as well, since it’s kept the kids happily occupied whilst the grownups have dealt with the other spectre lurking in the shadows: the Congressional mid-term elections.

As predicted, these elections have moved the country from Democratic control to a uniquely US brand of “No Overall Control” politics: a Democratic president, Democratic control of the Senate (but by the slimmest of margins), and significant Republican control of the House of Representatives. This is Good News for the Republicans, who now get greater influence on federal...

According to Phyllis Meras’ The historic shops & restaurants of Boston, nineteen year old Francis Xavier Masse arrived in Cambridge in 1881 with a handful of dollars to seek work in the clay pits of Cambridge’s New England Brick Company. 

Getting off the train, the scent of fresh rolls tempted him into a nearby bakery, and before he left, he was hired there.  Later on Masse got involved in running the place, and, it seems, with his boss’s daughter, whom he married in 1888.

Soon after, his formidable gift of combining opportunity with passion also led him...

The US’s flirtation with liberalism lasted precisely one year, the time it took to go from staring doe-eyed at the newly inaugurated Barack Obama to sucking the face off model republican Scott Brown. Massachusetts voters last week replaced Ted Kennedy – the man who dragged the US kicking and screaming to Alma Ata and whose last legislative wish was to secure the passage of health care reform – with sometime tea-bagger [i] Brown, whose first priority will be to block it. And if he really wants to he can: the election left the Democrats one senator short of the 60 they need to carry their...

In the course of my clinical career, there are many things that I look back on and wish that I had done better. Conversations that went badly with patients, decisions about treatments, heated debates with colleagues are often played over and over. I think about the wins as well, though perhaps not as much. As a medical registrar, most centre around getting someone home feeling better than when they came in.

Someone that I remember well was a young Egyptian-born man with a particularly aggressive form of leukemia whose disease relapsed after treatment. Born in Cairo and living in east...

US health care reform rages on, inflaming the kind of passions that in the UK are reserved for the hunting of foxes and MPs’ expenses claims.  Over the past few weeks the legislative spotlight has moved from the Senate to the House of Representatives, and members of the lower house have been revelling in it. Republican Michele Bachmann has, during the course of her blood feud against the reforms, revealed the Democrats’ bill for what it is: a sinister plot against the elderly and the unborn, complete with death panels and...