By David Woods (

HOC editor David Woods has just returned from attending two healthcare congresses.

Fourth Annual World Health Care Congress (WHC), Washington, DC, 22–24 April

A panel on competition, moderated by John Iglehart, the founding editor of Health Affairs, included Michael Porter, a Harvard professor and a leading authority on competitive strategy, who said that 21st-century medicine is being delivered with 19th-century organisation and management.

What’s called for, he said, is a fundamental restructuring of health systems rather than incremental improvement, and an emphasis on value and on health outcomes per dollar spent. True competition must be based on measurable results, not process, he said; and while information technology is an enabler, it’s not a solution. Restructuring must come from the bottom up and physicians have to ‘get out of the bunker’ to lead the change…

International Society for Healthcare Publication Professionals (ISMPP), Third annual meeting, Philadelphia, PA, 23–25 April

“Ensuring integrity in medical publications: conflicts, credibility and collaboration” was the conference theme, and the highlight was a panel discussion that featured all three of those in a sometimes heated but always engaging debate on conflict of interest.

Faith McLellan, North American senior editor of The Lancet, pointed out several examples of scientific fraud, including one perpetrated by a scientist who made up data on 960 patients – but gave them all the same date of birth. The lessons learned about conflict of interest, she said, are: slow down, develop more rigorous peer review and get a better handle on who the authors are and what they actually did…