To fix healthcare, doctors need to take a really good look in the mirror

The Academy also called for educating doctors to have a better understanding of medical literature and ensure that they conveyed information to patients on the benefits and harms of interventions in a more ethical and transparent way. Almost a decade later, there is no evidence of any of the Academy's key recommendations being implemented into clinical practice.

Shared decision-making has the potential to save the NHS billions, and improve patient satisfaction and outcomes. It would, however, cause a considerable dent in the profits of the pharmaceutical industry because patients, when fully informed, tend to choose fewer treatments.

Cholesterol-lowering drugs are a trillion-dollar industry, but how many patients with a less than 20 per cent risk of a cardiovascular event in the next decade (the majority prescribed globally) are explicitly told by their doctor that the absolute benefit of taking a statin is approximately 1 in 100 of preventing a non-fatal heart attack or non-disabling stroke with no mortality benefit over a 5 year period?

Drug companies have a fiduciary obligation to produce profit for their shareholders, but they have no legal obligation to give you the best treatment. As Cardiologist Peter Wilmshurst points out, the real scandal is that many of those with a responsibility to patients and scientific integrity (doctors, academic institutions, and medical journals) collude with industry for financial gain. The downstream effect also leads to a corporatised culture within healthcare where shortcomings in ethical standards can usurp patient needs.

Prior to exposing a cover-up by the Department of Health and NHS England of ambulance delays (including that which contributed to my father's death) in the national press, I informed a training program director in Cardiology of what I was about to do, to which he replied, 'I would advise you not to, you make yourself enemies and there is no benefit to you.'

Medicine is hierarchical and obedient. If large sections of medical leadership don't start to adhere to the highest standards of ethical conduct and evidence-based medicine our patients and healthcare workers will continue to suffer unnecessarily. If patient outcomes are optimised, there is better job satisfaction, increased morale, and less stress on health services. The elephant in the room is that to fix healthcare, the medical profession itself needs to start to take a really good look in the mirror.