Antibiotics: resistance and costs

The progressive power loss of antimicrobials against the most active microorganisms in infectious disease, especially in the hospital setting, makes systematic intervention absolutely necessary to optimize its prolonged use and its life, especially considering that there is sufficient evidence to think that with well-structured programs, we can reduce resistance and therefore solve very complicated clinical situations and in turn, lower the costs. A clear case of "Triple Aim", remember?: a) better quality, b) better outcomes, and c) lower costs.

What is ASP (PROA in Spanish)?

Persuasion is not the way to changing behaviours

Don’t Persuade Customers — Just Change Their Behavior http://t.co/K9QVUK7FhS
— Harvard Biz Review (@HarvardBiz) February 10, 2014

Harvard Business Review’s tweet links back to their own blog where you’ll find a post signed by Art Markman, a professor at the University of Texas and author of "Smart Thinking"  a book about traditional topics of marketing on how to change attitudes and ultimately sell more and for this reason the first thing I thought of when reading the promotional post of the book was that these are issues specific to the commercial world, so far from clinical management. But then I gave it another try and suddenly I found an interest in the author’s approach to the topic.

"Too much mamography" or the mirage of screenings

By Cristina Roure @crouren

The BMJ recently published the results of a randomized Canadian study which shows that annual mammography in asymptomatic women under 60 does not bring any advantage in reducing mortality from breast cancer compared with physical examination without mammography and, instead, it leads to more than 20% over diagnosis. The article is accompanied by an editorial entitled "Too much mamography" which suggests the need to rethink the breast screening policies as it has done with PSA screening in the case of prostate cancer.

It can be somewhat counterintuitive to think that a test that can detect cancer early and therefore provide the opportunity to treat it early, does not reduce mortality, but often not only the citizens but also the professionals have difficulty interpreting the benefits and risks of screenings and to communicate them clearly to patients when making the decision to participate or not in the program. Gerd Gigerenzer, Director of the Max Planck Institute for Human Development in Berlin explains it very well in his book Calculated Risks. How to know when numbers deceive you¹.

Differences between a leader and a manager

Las diferencias entre un líder y un gestor - John Sculley http://t.co/Y9U4xssKv6
— Julio Mayol (@juliomayol) February 22, 2014

The tweet edited by Julio Mayol lead to a video about an intervention of John Sculley, Chief Executive Officer (CEO) at the beginning of Apple. Those who have seen the movie about the life of Steve Jobs will recall that Sculley was the Pepsi Cola manager joining a young and sassy Apple, in order to turn it into a business. Those who have not seen it should know that this ended badly, especially because the leader, Steve, had a vision focused on innovation, while the businessman was focused on market and profits. Jobs was fired in 1985 and the company without him, continued fighting in an emerging market, with good results, as Sculley wanted, but without the punch of a leader. Jobs ended up buying Apple, thirteen years later, when the company, now without Sculley managing it, went into bankruptcy.

These two figures: the leader and the manager are essential for businesses, both public and private ones alike. The leader is associated with the vision, and thus with a project, while the manager is associated with a board of directors or the public administration directly. The success of institutions relies on the two figures finding a common work field where they can negotiate and share objectives. From Jobs-Sculley type confrontations, only resounding failures for both parties can arise.


Jordi Varela

Editor