UK government plans to increase the price the NHS pays for drugs will face a legal challenge from a patient campaign group.The changes, announced in December 2025, formed a key part of a trade deal aimed at avoiding tariffs being imposed by the US president, Donald Trump.1These new regulations would allow ministers to increase the cost threshold that the National Institute for Health and Care Excellence (NICE) uses to determine which drugs are made routinely available in the health service from a range of £20 000-£30 000 per quality adjusted life year to £25 000-£35 000. The change is expected to cost the NHS billions, which critics say could be better spent improving services.But these plans are now being challenged by Just Treatment, a patient led campaign group working alongside Global Justice Now, a social justice organisation. The two groups have written to the secretary of state for health and...

Regulations for handling “vexatious” patients must be toughened to protect GPs and their staff against the growing threat of harassment and abuse, general practice leaders say.The UK conference of local medical committees (LMCs) in Belfast heard distressing accounts from GPs about doctors, staff, and their families being harassed, stalked, and targeted by patients.Delegates said that current rules on handling patients who engage in repeated harassment, stalking, or abuse did not adequately protect doctors and staff against what was a growing problem.Claire Barnsley, of Wakefield LMC, who proposed the motion, said, “Harassment and stalking are patterned based forms of abuse, not single instance. They escalate over time, and in modern general practice they are increasingly enabled by our own systems.“Police thresholds are high and inconsistently applied. NHS systems compel repeated engagement with patients demonstrating vexatious behaviours, even after abusive or threatening behaviours.”GPs have consistently highlighted the need to deal with abuse...

Davies provides a salutary reminder of the harm that can be caused by the diagnoses we make.1 Most melanoma in situ is biologically indolent and will never progress, and the dramatic rise in incidence is largely a marker of diagnostic scrutiny. The absence of a corresponding fall in invasive melanomas is the hallmark of overdiagnosis.2 I hope she will take consolation from the fact that a diagnosis of melanoma in situ is associated with an overall reduced risk of death from any cause over the 15 years after diagnosis, which greatly exceeds any (exceedingly small) risk of death from melanoma.3Overdiagnosis of melanoma is being recognised as a major problem in dermatology.45 Several factors have contributed, including social media messaging; government cancer targets with increased melanoma awareness; and for-profit “mole screening” shops on high streets, open to anyone despite the absence of any evidence that undirected mole screening reduces melanoma mortality....

A new outbreak of Ebola virus disease in central Africa, caused by the rare Bundibugyo version of the virus, has caused more than 300 suspected cases and killed 100 people, health officials have said.The World Health Organization (WHO) has declared the situation a public health emergency of international concern.1The Africa Centres for Disease Control and Prevention (Africa CDC) has so far identified 336 suspected and 10 confirmed cases in the Democratic Republic of the Congo (DRC).2 There have been 87 deaths in the DRC to date. Uganda has had two confirmed cases and one additional death.3In response WHO has sent five tonnes of medical supplies to the DRC, and $500 000 (£374 000; €430 000) has been released from the agency's contingency fund for emergencies.This Ebola outbreak is causing particular concern because it has been caused by the Bundibugyo strain, which has been detected in only two previous outbreaks, in...

Screening with a PSA (prostate specific antigen) blood test reduces prostate cancer deaths by two for every 1000 men screened, though the risk of overdiagnosis remains high, an updated Cochrane review says.1The evidence of a “modest” benefit is a shift from a 2013 Cochrane review that concluded there was not enough evidence that screening reduced prostate cancer deaths.In the UK, more than 64 000 men are given a prostate cancer diagnosis every year, and one in eight will receive a diagnosis in their lifetime.The merits of routine screening for prostate cancer have long been debated. In recent years there has been high profile campaigning for PSA testing to be rolled out more widely, including by former prime ministers Rishi Sunak and David Cameron and the Olympic cyclist Chris Hoy.However, last year the UK National Screening Committee advised against routine screening for prostate cancer, saying the harms outweighed the benefits.2 Instead...

I want to take a career break—what do I need to know?Considering why you want to take a break and what you want to achieve can be a great place to start.Lucy Henshall—founder of Welcome Back to Work (https://www.welcomebacktowork.co.uk/), which provides support for GPs returning to work after a break—says: “You need to decide what is important to you.“People take career breaks for many different reasons, and there is no right or wrong path. It is a very personal decision that needs careful thought to minimise the hurdles and mitigate the risks when you do return to medicine.”Henshall, a retired GP, says that taking breaks was not the norm when she qualified back in 1987 but that “times have changed.”“Life is much more complicated for young medics now—and student debts are higher than ever,” she says. “The heady combination of excessive workloads, financial pressures, social isolation due to frequent geographic...

One French woman and one US national who disembarked from the cruise ship MV Hondius have now tested positive for hantavirus.Another US national was also reported as showing symptoms of possible infection. The fresh wave of cases came as passengers disembarking the ship were repatriated after the MV Hondius docked in the Canary Islands on the morning of 10 May.The World Health Organization (WHO) has confirmed that the hantavirus outbreak on the ship1 was caused by the Andes strain of the virus, which has been known to spread between people. As of 8 May eight cases were confirmed or suspected on board, of which three had proved fatal. By 10 May this had risen to 10 cases, said US and Spanish officials.Giulia Gallo, postdoctoral scientist in the viral glycoproteins group at the UK’s Pirbright Institute, said that the potentially new cases derived from the same cluster of exposed people on...

A risky gamble?It’s certainly a controversial one. But the practice of staking money on the likelihood of disease outbreaks or future pandemics is a growing trend, with gamblers flocking to online prediction market platforms like Polymarket to lay down their money.1High stakes?You bet. In the wake of the hantavirus outbreak on a cruise ship, traders are placing wagers on whether it will escalate into a pandemic1 (as defined by the World Health Organization) before the end of 2026. As of 11 May, a whopping $6m has been staked.What are prediction markets?Essentially, they allow people to bet on the outcomes of future events. Online platforms like Polymarket and Kalshi allow users to stake money on all manner of events such as elections, sports results, and major global events.Dead pool?The hantavirus market is the latest controversial market to emerge. Recently, gamblers started placing bets on how many people would be infected with...

In this paper by Sandbank and colleagues (BMJ 2023;383: e076733, doi:10.1136/bmj-2023-076733, published 14 November 2023), supplementary tables S3 and S4 included limited reference information. These tables have been corrected to include full reference information.

Doctors who have been struck off in one European Union country are continuing to practise in another, an investigation has found.News outlets De Tijd, Le Monde, and France Télévision found that four French doctors barred from practising in France had subsequently obtained licences in Belgium.1One doctor was a 65 year old French cardiologist convicted in April 2024 of sexually assaulting his patients in France. The Brussels based Iris Hospitals South that hired him said it was not aware he had a criminal record until it was contacted by journalists.The hospital group said it had followed procedures by checking the practitioner’s licence with Belgium’s Federal Public Service for Health and the Order of Physicians.“The hospital had no legal basis, or any indication whatsoever, that would allow it to identify or suspect such a situation,” hospital spokesperson Céline Barcham said. After being alerted to the cardiologist’s past, the hospital fired him in...

Thirty US psychiatrists and other doctors specialising in mental health have signed a statement declaring President Donald Trump mentally unfit to serve, warning that his ability to launch nuclear weapons is a “danger” to the world.The signatories say that Trump’s behaviour over the past year has shown “objectively observable signs of serious medical concern.”They cited examples of his “marked deterioration in cognitive functioning,” “episodes of apparent somnolence during critical public proceedings,” “severely impaired judgment and impulse control,” and “significant loss of self-control,” as well as “grandiose and delusional beliefs, including assertions of infallibility, imagery of himself as Pope suggestive of a divine mission.”The doctors called for Trump’s immediate removal from office, arguing that he presents a “clear and present danger” to the whole world.“It is our expert opinion that Donald J Trump is mentally unfit to be the president of the United States and that steps to remove him from...

Lawyers for the US state of Pennsylvania have filed a lawsuit against a company it alleges is allowing a chatbot to impersonate a doctor.1Pennsylvania filed the action against the tech company Character.AI after a state investigator posing as a patient was told by an AI chatbot that it was licensed to practise medicine in Pennsylvania and the UK and provided a fake Pennsylvania medical licence number.“We will not allow companies to deploy AI tools that mislead people into believing they are receiving advice from a licensed medical professional,” said Josh Shapiro, governor of Pennsylvania, in a statement announcing the lawsuit.2Character.AI allows users to interact with themed AI personas that can pose as particular people, members of certain professions, or fictional characters. Responding to the lawsuit, a Character.AI spokesperson said, “We have taken robust steps to make that clear, including prominent disclaimers in every chat to remind users that a Character...

Doctors who prescribe psychiatric medications should regularly review whether the drugs are effective and, if not, consider deprescribing and using non-medication approaches, the Trump administration announced in an “action plan” to tackle overprescribing.“Today, we take clear and decisive action to confront our nation’s mental health crisis by addressing the overuse of psychiatric medications—especially among children,” said the health and human services secretary, Robert F Kennedy Jr.1“We will support patient autonomy, require informed consent and shared decision making, and shift the standard of care toward prevention, transparency, and a more holistic approach to mental health,” he added.The idea that overprescribing of psychiatric drugs is harming young people has been a popular topic for Kennedy for many years. “We are not just overmedicating our children, we are overmedicating our entire population,” he said at his 2025 confirmation hearing.2 He told that hearing that 15% of US children were taking drugs for attention...

Artificial intelligence (AI) is becoming part of everyday clinical life. From drafting clinic letters to suggesting differential diagnoses, it is changing how we learn and practise medicine. For doctors in training, its use can often feel like progress, saving time, reducing uncertainty, and making us more efficient. But we should pause before celebrating too quickly. If we rely on AI too early in our clinical training, before core clinical reasoning skills are fully developed, we risk losing the one skill that defines our profession: the ability to think.Recent evidence suggests that this risk is not theoretical. In a multicentre, observational study, endoscopists who routinely used AI to detect polyps saw their accuracy drop when they performed colonoscopies without AI assistance.1The adenoma detection rate fell from 28% to 22% after just a few months of exposure.1 The researchers concluded that continuous exposure to AI might dull independent ability, subtly changing how...

“So, I’m a rheumatologist—obviously we specialise in gossip,” Matthew Hutchinson says, pausing before clarifying the pun: “rumour.”Humour might be the entry point to Are You Really the Doctor? but Hutchinson’s book touches on difficult topics—from examining what it means to practise medicine to navigating race, identity, and institutional power in the NHS.Medicine can be a challenging profession, and Hutchinson turned to comedy initially as a pressure valve—a way to manage the stress of frontline medical work. “Having something outside of medicine helps to keep perspective, stay sane, and keep going,” he says.Hutchinson, also a PhD candidate as well as a stand-up comic and soon-to-be consultant, writes not simply about being a black doctor, but about how identity shapes clinical encounters, professional expectations, and public trust. Comedy, he says, is not a detour from medicine but a lens through which to examine it.Belonging and perceptions of credibility and competenceIn Hutchinson’s book,...

What is hantavirus?Hantavirus is not one virus but a group of negative stranded RNA viruses in the family Hantaviridae, within the order Bunyavirales. They contain three segments of single stranded, negative ribonucleic acid (RNA) molecules.2 The viruses are primarily carried by rodents such as mice, rats, and voles. People usually contract disease from them through exposure to rodent urine, faeces, and saliva.34Although relatively uncommon worldwide, with around 10 000 to 100 000 infections reported each year, the virus causes two diseases.5 The first, haemorrhagic fever with renal syndrome (HFRS)—formerly known as Korean haemorrhagic fever—was first detected in US soldiers fighting in Korea in the 1950s. The second, hantavirus pulmonary syndrome, or hantavirus cardiopulmonary syndrome (HPS/HCPS), was first recognised in a 1993 outbreak of severe respiratory disease in the Four Corners region of the southwestern United States.6The highest incidence of HFRS is in East Asia, particularly China, followed by Russia and...

Complications of diabetes pose a noticeable burden for individuals and society.12 In a recent review in The BMJ (doi:10.1136/BMJ-2024-081217), Fridman and colleagues describe advances in the pathophysiology and treatment of diabetic peripheral neuropathy (DPN).3 The review of DPN covers epidemiology and risk factors, pathophysiology, diagnosis, treatment, as well as global considerations.3 The authors acknowledge that translation of emerging evidence into clinical practice remains challenging. However, since microvascular complications of diabetes are often systemic,45 clinical assessments should account for the patient’s total complication burden.In the review, the authors suggest that the presence of atypical neurological features should lead to more extensive investigations, such as electrodiagnostic testing to explore alternative causes of peripheral neuropathy.6 However, this should also be the case if there is peripheral neuropathy without accompanying retinopathy. Clinical assessment should also involve consideration of autonomic neuropathic features. For example QTc prolongation in those presenting with type 2 diabetes and foot...

Last year, Abbasi and colleagues highlighted the lack of progress towards nuclear disarmament.1 Recent US-Iran nuclear diplomacy probably followed a familiar script.2 Diplomats discussed enrichment levels, deterrence, regional security, and escalation risks, with input from intelligence, military, and foreign policy experts. But one voice was noticeably absent: doctors.Nuclear weapons are often treated as political tools, but their use would cause mass death, illness, and system collapse. Yet nuclear diplomacy proceeds as if medical expertise is optional, excluding doctors.In humanitarian settings, doctors are trained to anticipate unlikely scenarios with severe outcomes, from emerging infectious diseases to mass casualty events. By contrast, nuclear policy regards catastrophe as theoretical until it occurs, excluding professionals equipped to evaluate its medical consequences.Negotiators often rely on invisible medical optimism. They assume that healthcare systems would function, with hospitals operating, supply chains intact, doctors available, and long term care assured. These assumptions are infrequently stated, stress tested...

This Viewpoint discusses policies the Biden administration can enact to reduce costs, including benchmarking Medicare Part B drug payments to the lowest price paid in similar countries, preventing Part D plans from negotiating confidential rebates with manufacturers, and patent reform to promote generic drug use.

This Viewpoint reviews evidence that higher hospital prices reflect greater market power more than higher-quality services and proposes that backstop price caps can mitigate harms from the most excessive prices without constraining or distorting competitive health care markets.