Peggy:

I tried to access this website and got an URL error.  Is the address correct?

Sharlene

>>> pedwards <[log in to unmask]> 08/10/98 09:39PM >>>
 The British Mediccal Association Journal sent the following Customised
Alert (point your browser at http://www.bmj.com/cgi/customalert)--of 
interest to me and I suspect to many other health promotion specialists.

Peggy Edwards


BMJ 1998;317 ( 1 August )


Two unlike people

Popular newspaper editors always chose human over abstract stories.
People like reading about people, and doctors are no different. Yet
modern
medical journals lack stories about people. Case reports, which are
increasingly
rare anyway, are not about people but about cases: you usually learn more
about their serum biochemistry than about them as people. This issue of
the journal is thus unusual in having information on two people running
through the journal. Even more unusually one is a clear "goody" and the
other a "baddy." Gro Harlem Brundtland is seen as the saviour of the
World Health Organisation, while Chris Proctor is head of science and
regulation at British American Tobacco, the antichrist to many doctors.

Brundtland, who is interviewed by Adrea Mach (p 302), has taken over an
organisation that was dead on its feet. Several years ago the BMJ argued
that the WHO must "change or die," but little had changed until the
arrivalof Brundtland, a doctor and former prime minister of Norway. The
organisation had lost its vision and the staff their motivation. The
culture was secretive, opaque, and fearful.

When taking over such an organisation you must hit the ground running.
Brundtland came in like a tornado. She fired most of the senior staff and
installed 10 new senior staff, eight of them from outside the
organisation and six of them women. Management theorists debate whether
you can manage the culture of an organisation and generally believe that
you can't. One way you might is by wiping out the upper echelons. But
Brundtland, argues Fiona Godlee (p 296), has a hard job ahead, not least
in getting the regional directors on board.

One of Brundtland's priorities is to campaign against tobacco. She points
out that in China tobacco is likely to kill 50 million children and
youths alive today. One man Brundtland may encounter in her battles
against tobacco is Proctor, a non-medical doctor whose PhD is in
chemistry. Kamran Abbasi asked him if he had sold his soul to the devil
(p 301). "I don't
think I have," he answered, "and my kids don't think I have."

Proctor crops up twice more in this issue, which has a collection of
material on conflict of interest. Richard Smith argues that doctors and
medical journals must take conflict of interest more seriously (p 291),
but Proctor argues that peer review will protect against conflict of
interest. On p 333 he argues that researchers should collaborate with the
tobacco
industry rather than confront it, while Tom Sorell argues that tobacco
company funding instantly discredits research (p 334). Proctor also
appearsin the correspondence on passive smoking, putting the industry
case (p 349). Those who try to represent the scientific case of the
industry are kept busy, and, many readers will think, could be better
employed.



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