The unavoidable decision for medical societies: Commercial drift or integrity.

The History of the Royal Society of Medicine

"Bramwell, Sir Byrom, (18 Dec. 1847–27 April 1931), late President, Royal College of Physicians, Edinburgh; Consulting Physician, Edinburgh Royal Infirmary; Consulting Medical Officer, Scottish Union and National Insurance Company; late Government Medical Referee for Scotland; late President, Association of Physicians of Great Britain and Ireland; Hon. President, Royal Medical Society; Foreign Corresponding Member, Neurological Society of Paris, German Neurological Society, and Philadelphia Neurological Society; Hon. Member, Société des Medécins Russes de Petrograd, American Neurological Society, Northumberland and Durham Medical and Clinical Societies, Sunderland Medical Society, and Manchester Medical Society" published on by Oxford University Press.

This paper reappraises the role of medical clubs and societies in the production and consumption of knowledge in 18th-century Scotland and the wider North Atlantic world. It focuses on the Edinburgh Medical Society, founded in 1731 by Alexander Monro primus; and on the student Medical Society, founded in 1734 and constituted in 1737 as the Medical Society of Edinburgh, ultimately becoming the Royal Medical Society of Edinburgh in 1778. The paper examines how Monro, as editor of the transactions of the Edinburgh Medical Society, sought to adapt medical learning to a world of polite sociability; and how that world came under pressure in the student Medical Society, where prevailing orthodoxies, such as the system of Herman Boerhaave and, later, William Cullen, were challenged. In the febrile atmosphere of the 1790s, William Thomson accused the Royal Medical Society of Edinburgh of promoting visionary theories and abandoning the proper experimental method in medical science. Yet with its overarching commitment to the sceptical and empirical principles laid down by the Royal Society of London (founded in 1660), the Royal Medical Society of Edinburgh provided a model for the establishment of similar clubs and societies on both sides of the Atlantic.

This paper reappraises the role of medical clubs and societies in the production and consumption of knowledge in 18th-century Scotland and the wider North Atlantic world. It focuses on the Edinburgh Medical Society, founded in 1731 by Alexander Monro primus; and on the student Medical Society, founded in 1734 and constituted in 1737 as the Medical Society of Edinburgh, ultimately becoming the Royal Medical Society of Edinburgh in 1778. The paper examines how Monro, as editor of the transactions of the Edinburgh Medical Society, sought to adapt medical learning to a world of polite sociability; and how that world came under pressure in the student Medical Society, where prevailing orthodoxies, such as the system of Herman Boerhaave and, later, William Cullen, were challenged. In the febrile atmosphere of the 1790s, William Thomson accused the Royal Medical Society of Edinburgh of promoting visionary theories and abandoning the proper experimental method in medical science. Yet with its overarching commitment to the sceptical and empirical principles laid down by the Royal Society of London (founded in 1660), the Royal Medical Society of Edinburgh provided a model for the establishment of similar clubs and societies on both sides of the Atlantic.

COVID-19 Era Impacts on the American Academy of Ophthalmology

Keeping professionally up to date in 18th-century Britain was not an easy undertaking. Learning on the job was insufficient for the further development of individual medical knowledge. The century witnessed the gradual growth of medical societies to provide a better education than that offered by university institutions. The Worshipful Society of Apothecaries of London in 1815 was empowered to licence and regulate medical practitioners, today's general practitioners. Societies were established in Edinburgh but not so many as around London, where a particularly successful education body was established in 1773, the prestigious Medical Society of London. In 1805 a breakaway group from the society formed an equally highly respected learned body, the Medical and Chirurgical Society of London, that became the nidus for the amalgamation of numerous specialist societies to form, in June 1907, the extant Royal Society of Medicine. By the end of the 18th century, the medical society had fostered professionalism, education and unification within diverse medical and scientific disciplines.

Trends of Representation of Women in Professional Medical Societal Leadership in the United States and Europe.

With a membership of just over 17 500 the Royal Society of Medicine is the largest medical society in Britain. Its ancestor, the Medical and Chirurgical Society of London, was...

Where Are the Women? The Underrepresentation of Women Physicians Among Recognition Award Recipients From Medical Specialty Societies

Women in Anesthesiology Leadership: The Time is Now

In the framework of PartecipaSalute--an Italian research project aimed to involve lay people, patients' associations and scientific-medical representatives on the health debate --we carried out a survey with the Italian Federation of Medical Societies. The aims of the survey were to know medical societies attitude vs. patients involvement in research activities and healthcare setting and to find out possible projects conducted in partnership with patients associations. A web-questionnaire with 17 closed questions, and three open questions has been prepared on the basis of some experiences published on the literature and through the collaboration of members of the Italian Federation of Medical Societies. A total of 205 medical societies has been contacted by e-mail with a cover letter explaining the aims of the survey. At the end 74 medical societies completed the survey. Medical societies participating to the survey varied widely in terms of years of activity, number of members, and geographical distribution. Remarkably, 36 medical societies respondent organized collaborative initiatives with patients/consumers associations during the last three years. Among these, the most frequent were the preparation of written material for patients, organization of conferences or workshops, and health awareness campaigns. Moreover, 6 medical societies published documents on patients' rights but patients or their associations were involved in only 2 of these initiatives. Advantages and disadvantages reported by medical societies answering are also presented and discussed. In conclusion, to our knowledge this is the first survey on the value of patients' involvement conducted together with medical societies in Italy, and the results point the way to stronger collaboration in future between patients' associations and medical societies.

A new partnership between <i>Acta Radiologica</i> and Royal Society of Medicine Press

Codes of professional conduct continue to be an essential component of maintaining the integrity of individuals, academic institutions, and medical societies. We review ethical issues of professional conduct focusing on conflicts of interest (COI). We explain how to manage or mitigate COI in the context of professionals involved in headache medicine and its medical specialty societies. We identify the roles of institutional, medical society, and governmental regulation in the protection of patients and maintaining the integrity of physicians and others involved in patient care.

In Switzerland, clinical practice guidelines (CPGs) are not generally registered by a single central institution. Therefore, the total number and overall quality of the existing guidelines are not known. Our aim was to identify and describe the characteristics of current CPGs developed or endorsed by Swiss medical societies, by conducting a comprehensive systematic search. A systematic search was done in two medical literature databases (PubMed and OVID), two major non-indexed Swiss medical journals, Swiss medical societies&rsquo; websites and the FMH guidelines platform. Synonyms of &ldquo;guidelines&rdquo; in English, German, French and Italian were used as search terms, complemented by a hand search. Inclusion criteria for the retrieved documents were that they: (1) contained recommendations for patient care provided by physicians; (2) defined specific clinical circumstances; (3) were developed, adapted or endorsed by one of the Swiss national medical specialty societies. Documents with publication date before 1 January 2008 or containing only general and public health recommendations were excluded. Retrieved documents were screened by two reviewers in parallel. Data on the reported methods as well as transparency and quality indicators of the CPGs were extracted in a standardised way. A total of 295 CPGs were included in the analysis, 199 of which were found only on the societies&rsquo; websites, 44 only in the literature and 13 only on the FMH platform. Overall, 159 (54%) of guidelines had at least one predefined keyword in the title, most frequently &ldquo;Empfehlung&rdquo; or &ldquo;guideline&rdquo;. Health areas with the highest number of CPGs were cardiovascular (55) and infectious (52) diseases. Most CPGs were developed in Switzerland (212); the rest were developed in cooperation with German societies (6) or with both German and Austrian societies (23), or by other international organisations (54). At least one author and the date of publication were reported in 83% and 94% of guidelines, respectively. Conflicts of interest were stated in 44% and financial support documented in 29% of the guidelines. Any method of guideline development was mentioned in 56%. Numerous CPGs provide recommendations for clinical practice in Switzerland. The majority are published on medical societies&rsquo; websites only. The quality of reporting is extremely heterogeneous, ranging from documents without reported authors, methods of development and publication date, to graded, continuously updated guidelines based on a systematic review of evidence. CPGs could potentially be improved by using a standardised development and reporting framework.

PATIENTS, PHYSICIANS, NURSES, EMPLOYERS, PAYERS, AND other players in the health care system are directly affected by the severe limitations of the current US health care delivery and reimbursement system. The future will be worse unless the root causes of this dysfunction are addressed. The symptoms are fairly clear and the data to support a diagnosis as well as potential therapeutic options are available. Unwarranted variation in the delivery of care contributes to the lack of a relationship between what is spent on health care and the quality of the services delivered. Other countries that spend far less per capita on health care than the United States deliver care that is more equitable, effective, and efficient and is safer and more patient-centered than is provided in the United States. The United States is slipping further behind other countries in areas such as amenable mortality and ranks poorly compared with several other countries on important attributes such as access and safety. Research suggests that the presence and support of a robust primary care system is a major characteristic of an efficient and high-quality health care delivery. This has been demonstrated in other countries as well as in the United States. However, the future of the US primary care system is uncertain at best and is perilously close to collapse at worst. Fewer medical students and residents are choosing primary care specialties, and physicians in practice are leaving internal medicine faster than their other colleagues with a subspecialty. Recent workforce analyses highlight this trend and the lack of a foreseeable change in the projections for the availability of primary care physicians. Furthermore, the poor outlook for the supply of physicians with special training in geriatrics is well documented. Even though reimbursement is not the only driver of the system’s dysfunction, payment based almost solely on the volume of care provided—even with a small performance-based component based on measures of quality—will not attract medical students and residents to primary care. In addition, it does not provide the necessary incentives or capital for physicians to invest in practice enhancements, systems of care, or health information technology. In the past few years, the American Academy of Family Physicians (AAFP) and American College of Physicians (ACP) independently advanced policies to advocate for change in the health care delivery and reimbursement system based on the concept of the medical home, which was originally described in the 1960s by the American Academy of Pediatrics (AAP). However, several large employers (especially IBM Corporation) encouraged the ACP, AAFP, AAP, and American Osteopathic Association (AOA) to synthesize their respective viewpoints into a unified concept and subsequently agreed to collectively promote the Joint Principles of the Patient-Centered Medical Home (PCMH) as a model of health care to test through demonstration projects. The principles, originally developed in late 2006, were released publicly in February 2007. They have attracted considerable attention and are now endorsed by several other medical professional societies. In March 2007, the Patient-Centered Primary Care Collaborative (PCPCC) was formed. This formation was motivated by the health care model as well as by the new collaboration between the medical societies and a group of large US employers. The PCPCC now counts among its supporters more than 160 organizations representing more than 50 million employees/beneficiaries all supportive of the PCMH model and testing of both the practice transformation elements as well as new methods of reimbursement. More importantly, the call for testing of the PCMH is now embedded in legislation (the Medicare Medical Home Demonstration Project authorized in the Tax Relief and Health Care Act of 2006) and forms the basis of several demonstration projects across the United States that include multiple commercial payers, state Medicaid agencies, regional and national employers, business groups, quality improvement programs, and national/regional medical professional societies. Many of these demonstration projects are being developed with input from health services researchers and