Reasons to be hopeful: Streams of renewal in healthcare

Date of this Version


Document Type

Journal Article

Publication Details

Published version

Moynihan, R. (2012). Reasons to be hopeful: Streams of renewal in healthcare. BMJ, 345, e6042

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2012 HERDC submission. For codes: 111799; 119999

© Copyright BMJ Publishing Group Ltd, 2012




Extract: The iconoclastic former BMJ editor Richard Smith has mused that medicine might need to feel utterly defeated for it to undergo much needed radical renewal.1 Whether or not defeat is imminent, a culture shift is being debated,2 and renewal is inevitable. The current medical-industrial paradigm—fragmented, technocratic, mechanistic, inhuman, and imperial—is neither healthy nor sustainable. While there’s much that is hopeful in debates about clinical medicine, public health, and beyond, I’d like to identify 10 streams of change that may ultimately coalesce to form a coherent vision of radical renewal.



This document has been peer reviewed.