Family Practice Vol. 16, No. 5, 545
© Oxford University Press 1999
Book Reviews |
Clinical futures.
GP and Professor of General Practice at Imperial College School of Medicine
M Marinker, M Peckham (eds). (224 pages, £19.95.) BMJ Publishing Group, 1998. ISBN 0-7279-1231-3.
This is a thought-provoking book and that may be sufficient recommendation in itself. Marshall Marinker is well known for his fearless ‘trapeze artist’ discus-sions of medical futures. He is joined here as editor by Michael Peckham, who brings a broad perspective, tempered by his experience in leading the Research and Development initiative in the UK National Health Service (NHS). While the theories of the various futures are universal, their applications are outlined in the NHS context.
The two editors invited seven leading biomedical researchers to look 50 years ahead in their own field. The book aims to give a contrast to the "burgeoning literature of health-care policy, much of it stemming from the perspectives of political and social theorists". Marinker introduces the whole and clearly enjoys giving us a preview of the tastiest morsels from the fare ahead. As he says, "our writers found half a century a tad ambitious". This is just as well because the greatest strength of the book is its jargon-free review of the present and immediate future.
Highlights of the book include Bell's review of the human genome, which informs aspects of specialist chapters from Sikora (cancer), Poole-Wilson (cardiology) and Catherine Peckham (child health). I was even more enlightened by Delpy on engineering in medicine, perhaps, as he hints, because the relevant scientists are not so closely linked with clinicians. However, while all authors were informative about their speciality, generalist readers of Family Practice may be amused and even amazed by their vision of the interface between biomedicine and the public and patients. Both Sikora and Catherine Peckham predict an expansion of interest in complementary medicine, while Poole-Wilson is worried by journalists with insufficient scientific education. He also states that "far too much of current medical resources are spent on health care in the last year of life". Grimley-Evans (on ageing) asks "where will the sense of fruition, of the aim and purpose of life be found?" and goes on to remark that "the charms of great-great grandchildren may prove uncompelling".
Michael Peckham's final chapter is a wide-ranging commentary not clearly linked to the biomedical contributions. He examines a growing gulf between biomedicine and the expectations of society to a welcome degree. In the process he argues for a complete rethink of medical education in a new environment "as free as possible from the burden of historical legacies", that is a new medical school where "throughout there will be contact with patients, their families and former patients". I, for one, would like to work in such a medical school and I hope that Peckham's influence can help us create one.
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