Intended for healthcare professionals



BMJ 2003; 327 doi: (Published 18 September 2003) Cite this as: BMJ 2003;327:690

Hospitals would be more efficient if they were run more like car factories, according to the latest report in Health Europe ( 2003,2; 56-67). The authors say that overburdened hospitals often have hidden reserves of operational capacity that can be unlocked by examining their process flow. Hospitals that borrow process-flow techniques from manufacturing could treat more patients at lower cost.

Anthrax may not kill by inducing endotoxic shock. A study of the effects of anthrax toxin in rats ( Journal of Clinical Investigation 2003;112: 656-8) found that toxin-induced death is mediated not by cytokine release, as previously thought, but by hypoxia-induced liver failure. These results suggest that the treatments developed for cytokine mediated septic shock will not be appropriate for treating anthrax.

A study of the effects of direct to consumer advertising of drugs in the United States (wheres it's legal) and Canada (where it's not; but it seeps across the border) in primary care revealed two separate effects. The primary effect is that patients are susceptible to advertiser's claims. The secondary effect is that doctors are susceptible to patients' requests for advertised drugs, even though they were ambivalent about drugs patients had requested ( CMAJ 2003;169: 405-12).

It's good news for shift workers and night workers. If overall …

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