Re: We can change practice—can we also change culture? Yes. Culture and practice are intertwined.
I compare the 1960s and Today.
In my youth, the doctors were fairly foot-loose. If they did not gel in the practice of a particular group of GPs or a hospital, they moved. Easily.
They worked as ship‘s doctors, went to Australia, Canada, HM Overseas Civil Service, etc.
They challenged the employers - mostly politely. They suffered no harm.
I am an example.
I was not alone.
I organised a “hunger strike”, refusing to eat lousy mess food, buying in food.
The Hospital Secretary soon came to heel.
We, the doctors, were free to prescribe - from the BNF.
No nonsense of a hospital having its own formulary.
We did have drug company hospitality meals. We always challenged.
Challenging Authority, challenging the Rich, challenging the status quo was normal behaviour of us young doctors.
Please look at the BMJ rapid responses.
Discussion, debate, challenge to Authority - all conspicuous by their absence.
Failure or more accurately, REFUSAL by the management to provide adequate safety equipment, training in its use have been blamed for fatalities during the current epidemic.
Are drugs, including vaccines and blood products, monitored conscientiously by the good doctors? I believe not. Remember hepatitis C, HIV?
The same goes for vaccines.
Do the government and inter-government agencies adequately look for adverse reactIons and hold the manufacturers to account?
Competing interests: I, as a patient, am at the receiving end.