number needed to treat

The hemoncology floor of Seattle Children’s Hospital performs...

Fri, 01 Jun 2012 09:17:36 -0500

The hemoncology floor of Seattle Children’s Hospital performs Kelly Clarkson’s song “Stronger”

This fun celebration of strength was thanks to Chris Rumble, a 22-year-old Children’s cancer patient who lives in Kent, Wash., who was recently diagnosed with leukemia in April. Chris had the idea to make a music video to share with his old hockey team in Wenatchee because his teammates had made him a music video for his birthday.

“I’m everyone’s big brother and I have a lot of friends here at Seattle Children’s,” says Chris. “I wanted to make a video to send back to my team and I thought what better way to do it then with the kids on my floor.”

[via medicalschool]

Self Portrait by Nacho Diaz via medicalstate

Wed, 30 May 2012 10:28:00 -0500

Self Portrait by Nacho Diaz via medicalstate

A Fast Food Burger Is 3 Times Larger Now Than in The 1950s from...

Wed, 23 May 2012 13:04:00 -0500

A Fast Food Burger Is 3 Times Larger Now Than in The 1950s from The Atlantic

It really is beginning to feel like that.

Sat, 19 May 2012 22:06:12 -0500

It really is beginning to feel like that.

jayparkinsonmd: Healthy food isn’t necessarily more expensive...

Thu, 17 May 2012 08:37:42 -0500

jayparkinsonmd:

Healthy food isn’t necessarily more expensive than junk food, according to a new government report.

Bittman was all over this months ago and I certainly agree.

via the WSJ

The biggest therapeutic advance in the past 10 years?

Wed, 16 May 2012 09:32:03 -0500

The biggest therapeutic advance in the past 10 years?:

Dr Centor has a pretty good candidate.

It’s an interesting and difficult question, one to ponder for a few days.

Any thoughts? Open for discussion in the comments below.

Constant quality improvement at the individual level

Wed, 16 May 2012 09:31:44 -0500

Constant quality improvement at the individual level:

Great example of how quality improvement can happen at the individual physician level.

What would happen if every clinician in an organization conducted their own small-scale improvement effort just like this and then shared the results with the whole institution? We could immediately see what works and what doesn’t, then dedicate resources to promising areas to further research their impact and scalability.

More importantly, it creates a culture of constant improvement and excellence that everyone is participating in at all times.

"My last piece of advice is this simple… Persevere. Because nothing worthwhile is easy."

Tue, 15 May 2012 08:25:37 -0500

“My last piece of advice is this simple… Persevere. Because nothing worthwhile is easy.”

- President Obama in his commencement address at Barnard College (via barackobama)

"We propose embracing a flipped-classroom model, in which students absorb an instructor’s..."

Fri, 04 May 2012 07:01:42 -0500

“We propose embracing a flipped-classroom model, in which students absorb an instructor’s lecture in a digital format as homework, freeing up class time for a focus on applications, including emotion-provoking simulation exercises.”

- Charles G. Prober MD and Chip Heath PhD writing in this week’s New England Journal of Medicine about the need to reform the format of medical education

I couldn’t agree more with the sentiment encapsulated in the quote above. Medical schools have done an excellent job in recent years of incorporating some alternative educational formats such as problem-based learning groups, interactive case-based lectures, and patient simulations. But these interactive and engaging learning activities only make up 10-20% of educational activities. Lectures still make up the bulk of coursework in medical school. As suggested by these authors, this ratio needs to be flipped with the majority of in-person learning occurring through interactive, case-based exercises while relegating lecture-based material to short electronic media formats.

One point missed by the authors in their commentary, however, is the need for collaboration among medical schools to pool their collective educational talent in pursuit of creating the absolute best electronic resources. Not every medical school has the best lecturers in all fields. By picking and choosing the best lecturers in biochemistry, physiology, pathology, anatomy, and pharmacology from each individual institution, we can provide students with the absolute best educational content.

This already occurs in the board review industry where publishers single out the best educators (or at least the most renowned) to write board prep books. Let’s bring this to all aspects of medical education to leverage content from the best educators delivered through electronic media to improve medical education for med students everywhere.

5 things med students can do to engage in social media and medicine

Thu, 03 May 2012 07:01:00 -0500

Last week, I had the distinct privilege of being invited to participate in the 27th Annual Student Physician Awareness Day at New York Medical College. The event—organized by first year medical students—focused on the influence of social media on medicine. The list of speakers included a veritable “who’s who” of physician-bloggers and health care social media experts. Kent Bottles, taking extensive long-hand notes, has written an excellent summary of the event.

Social media and medicine is a broad topic. The invited speakers did an incredible job of highlighting why social media is so important to the future of medicine while tempering an optimistic outlook with a dose of reality and cautionary tales about how some have gone astray in their social media use. I left the event inspired and hopeful for the future of medicine.

One topic we neglected, however, was what current medical students can do right now to get their foot in the door and begin engaging in the social media and medicine conversation. I had hoped to get to this topic during my panel discussion, but there just weren’t enough hours to cover everything. Below is my attempt to remedy this omission. Here are a few simple things you can do:

Listen in on the conversation—One of the first things taught to medical students is to listen to your patients. Today, a huge conversation about health care is occurring through social media and we need to be listening to what patients and thought-leaders are discussing. By and large, this conversation is happening on blogs and Twitter, as well as some other social media platforms. Sign-up for Twitter right now (use your real name) and simply listen to what is going on by following some hashtags. Click the “Discover” button at the top and skim through the discussion on the #hcsm (healthcare communications & social media) or #meded (medical education) tags.
Make connections—The social nature of the Internet now allows us to breakdown the barriers of time and space. Today, we can connect with virtually anyone, anywhere. Even more amazing is the melting of traditional hierarchical structures pervasive throughout medicine. Social media allows us lowly medical students to connect with CEOs of huge health corporations, renowned physicians and surgeons, innovators at the hottest health startups, and leaders in our own communities. But even more importantly, it allows us to connect with each other more efficiently and with patients. The growing ePatient movement now puts patient voices on equal footing with the traditional medical leaders. Social media is flattening the medical hierarchy and us medical students have a seat at the table.
Learn the tools—Many social media platforms exist. However, Twitter seems to be the dominant force today in the social media and medicine discussion. Twitter can be fully utilized through their site, but your experience can be greatly enhanced by employing other tools. Apps for your mobile devices are essential and allow you to stay up to date and participate in the discussion from anywhere. Twitter’s own apps for iOS devices and Android are great in their own right. I personally use Tweetbot on my iOS devices and Tweetdeck on my computer. Each set of tools has their strengths and weaknesses, figure out what works for you. And, while Twitter is the best place to start, don’t limit yourself. Explore the social media and medicine discussions on blogs and Facebook and Pintrest and Tumblr and whatever else you come across. New platforms are introduced everyday and people find great new uses for old platforms. Start with Twitter and go from there.
Research your future—Eventually we have to move on from medical school. (If you’re a second year studying for boards right now, you would like to move on TODAY.) For most, this means residency. By reading this post, you are already indicating you’re a forward-thinking med student interested in the future of medicine. Don’t you want a residency program and hospital that is at the forefront as well? Some residency programs and many hospitals have strong social media presences. By following what these organizations are putting out in the social media space, you can effectively discern what is important to them and what great things are going on at their institutions. This will help you find a match long before you set foot in a program director’s office for an interview. Maybe residency isn’t in your future plans. What better way to engage with research institutions, medical companies, health tech startups, public health organizations, government agencies and other potential employers than social media? You may find an entirely new career you had never considered before or carve out your own path. Engaging in social media only opens doors.
Have fun and practice professionalism—Engaging in social media as part of my medical career has been an incredibly enlightening and fun endeavor, as it should be. Always keep in mind that participating in the discussion is controlled by you. Med students lead busy lives. One of the best parts of social media is the ability to dictate your level of commitment. When I was studying for Step 1, I went nearly silent on my blog and Twitter account. I have the freedom to make that decision. At the same time, I also have the burden of engaging responsibly. I loathe how much attention is given to inappropriate use of social media by medical professionals, so I will leave you with the following advice: Social media platforms are public spaces. Treat them as you would any other public space by remembering you are a health care professional and your primary responsibility is to your patients. Your chief responsibility is safeguarding their privacy and comporting yourself in a professional manner.

Engaging in the social media and medicine discussion is an incredibly rewarding experience and will make you a better medical student and future physician. Hopefully these tips will get you started. Please leave any further suggestions or questions in the comments or contact me directly! I almost forgot, follow me on Twitter!!

"Any company that isn’t primarily delivering its service via mobile five years from now will probably..."

Tue, 01 May 2012 07:01:47 -0500

“Any company that isn’t primarily delivering its service via mobile five years from now will probably be irrelevant.”

- Keith Teare cited by Hamish McKenzie in Web 2.0 Is Over, All Hail the Age of Mobile on PandoDaily (via stoweboyd)

Only 54% of doctors say they would choose a career in medicine again...

Mon, 30 Apr 2012 21:14:56 -0500

Only 54% of doctors say they would choose a career in medicine again...:

Just read the quote from the pediatric oncologist. It says everything.

Via jayparkinsonmd:

Just 11% say they consider themselves “rich” — and 45% agree that “my income probably qualifies me as rich, but I have so many debts and expenses that I don’t feel rich.”

And a pediatric oncologist made an excellent comment:

With regard to the compensation bit, it is important to recognize that the student loan burden is enormous. Not only are you carrying over the loans from college, but your loans from medical school, and all of these tend to be held in limbo (“forbearance”) where they continue to earn interest that is capitalized/principalized, because during residency and fellowship (3-6 years beyond medical school graduation for medical specialists and 5-9 years beyond medical school graduation for surgical specialists) you’re making only $50K or $60K a year for your 80 hours a week work.

But I think one of the hardest bits is that during your school and training there’s never enough money to set aside, and certainly no 401(k) or pension, for retirement savings. So many of us start our “financial adulthood” in our 30s or even early 40s with a huge hole to fill - the need to save for retirement, to pay off the student loans, and at the same time, the need to start living like an adult (kids, house, non-disposable furniture, reliable transportation). And you start to get tired. When you’re 20-something or even in your early 30s, you can do the up-all-night/up-all-day thing, but when you’re in your early or mid 40s, it just gets really hard.

"Once there is no revenue, there is no science, and it all just becomes finger in the wind..."

Mon, 30 Apr 2012 09:59:12 -0500

“Once there is no revenue, there is no science, and it all just becomes finger in the wind valuations.”

- Paul Kedrosky—a venture investor and entrepreneur—as quoted in a NY Times piece by Nick Bilton on the Bits blog

I haven’t seen much evidence of this valuation bubble creeping into the med tech world (or perhaps I’ve just missed it) but the recent growth of health/med tech accelerators portends the future. These unfounded valuations will make their way to health/med tech companies and because of the closed nature of the medical world, there will be nothing around to pop the bubble. I fear that health insurance companies and large health care organizations that have no way to quantify the value of new technologies will pay huge sums for these new toys without any evidence that they truly add value. This could fuel even greater growth in health care costs.

expose-the-light: Ingredients of life Illustrations of Chemical...

Wed, 25 Apr 2012 18:21:19 -0500

expose-the-light:

Ingredients of life

Illustrations of Chemical compounds by Avkari Alon

Social media and medicine - topic of the day at NYMC

Mon, 23 Apr 2012 18:00:00 -0500

Social media and medicine - topic of the day at NYMC:

Tomorrow, some of the best and brightest physician-bloggers and other health care social media experts are converging at New York Medical College to discuss the impact of social media on medicine. I will be sitting on a panel in the afternoon to discuss social media and medical education, but I am by far more excited to have the opportunity to attend and hear these great talks. I think there are going to be some great, thought-provoking presentations. Follow #NYMCSPAD on Twitter throughout the day tomorrow and beyond to peek in on the discussion. They will also be posting videos of the conference later on (no live-streaming as I understand it). I will point everyone to the videos and other resources when they are available.