October 30, 2012
Happy Halloween: Med Ed style
Of course the sim center can make crazy cool costumes. They do make-believe for a living.
October 29, 2012
Cees van der Vleuten speaks!
Dr. van der Vleuten won the Karolinska Institutet Prize for Research in Medical Education this year. He was the plenary speaker at this year's University of Michigan Department of Medical Education's Medical Education Day. He is one of the most interesting voices in the world of medical education assessment.
You can hear him speak live online today Monday 29 October 2012 from 13:00-17:00 (European time) at ki.se/kiprime/live. That's in 20 minutes!
Another residency bill
Because we need more residencies---now!---there's another bill before Congress besides the bipartisan H.R. 6352 (from Allyson Schwartz and Aaron Schock).
Joseph Crowley has introduced H.R. 6562 which removes the cap on residency slots that's been in place since 1997. This raises 3,000 new slots a year for 5 years.
Weigh the cost of training an extra 15,000 residents each year against the cost of having hundreds of thousands of aging patients unable to find good primary medical care: it's a no-brainer.
October 27, 2012
Louisiana update 2
Speaking of needing more residencies, the poor folks at LSU are staring down a funding decrease that will shift a lot of residency training from public to private hospitals. I'm not against the shift though I wonder at the statement that "State officials have touted the decision to shift residencies...to private hospitals as a move that will provide better training." The LA State Medical Society is right to criticize the lack of transparency here.
We need a lot more blueprinting and a lot less wait and see.
ACGME and new residencies
So what could motivate the ACGME to withhold accredidation from a FSU program? It better be a real quality issue. I hope it's not due to interpretation of their new residency evaluation guidelines. Please please please make more residencies. Match day is coming up.
Congrats to Ruth-Marie Fincher!
October 23, 2012
I believe the children are our future
Targeted, evidence-based public health advocacy from M4s using multimedia published for free online. Not bad, St. Louis!
October 22, 2012
Here's more about Louisiana. One odd bit: the operating budget has been reduced 25% which will certainly demand redesign of education programs, which will demand reaccredidation, which will demand resources. It won't be pretty.
Hospitals are sad
This is an insight worth pursuing. If we want doctors to be more patient-centered, we'll need caring, sensitive people to go to medical school. If hospitals are sad, some of these people will be deterred.
October 10, 2012
Another medical school!
Keep 'em coming!
A stupid NYTimes article (part 1)
Okay I'm going to read the stupid thing.
Nope I had to stop when I hit this:
"He reached into a deep pocket of his white coat and produced not a well-thumbed handbook but his iPhone. With a tap on an app called MedCalc, he had enough answers within a minute to start the saline at precisely the right rate."
The thesis here is that since doctors can look up dosages and test values using a small computer instead of a book or notecard we all now live in a new age of medicine. That is absurd. Lookup tables are lookup tables. Perhaps the invention of the spiral notebook made similar waves in the health industry?
Plus: iPhone and MedCalc are trademarks which makes this article very ad-like. Also the doctor had the answer "[w]ithin a minute..."? I bet the "well-thumbed handbook" would have easily beaten that time. But at least MedCalc for iPhone provided "precisely" the correct answer.
(This is minor but I can't let the "[w]ith a tap on an app" crap slide. It's delightfully Seussian and that's fine. But 1) "app" is not really a word and 2) if it took only one tap I'll eat my cap. This writing is pap.)
My point is this: the passage overstates the innovation of a computerized look-up table over a paper one, it exaggerates the accuracy and ease of use of such things, and it slyly advertises for particular products while it does it.
God I loathe the New York Times. I'll try to get further through this article later, though. It's the paper of record, after all.
ACA: Louisiana edition
The Affordable Care Act is going to shake us all up. Here's the latest from LSU and it's complicated.
Bottom line: there will be a lot less money for taking care of uninsured people and for administration.
From my understanding, the big plan is to reduce the number of uninsured people drastically and stop paying so much for administration-heavy health care. Will it work?
Dr. Social Media
There's a New York Times article that was published a few days ago called Redefining Medicine with Apps and iPads and I can't bring myself to read it. The ugliness of the title is too much for me. "Redefining" medicine? What does that mean? "Apps"? You mean a trendy new fake-word for computer programs? "iPads"? You mean a registered trademark for a type of portable computer? Is this an advertisement? When I first got into the medical education game, everyone was convinced the PDA (remember that term?) would change medicine. Now it's "Apps and iPads?" Nope.
Doctors still carry pagers. Chew on that one for a bit.
But even so I'm pretty sure social media is going to be a big deal in medicine. It probably won't change anything about the clinical examination or treatments, but it definitely will change patient-physician interactions. But it will only have an effect if institutions allow doctors to use it. Patients really want doctors to use it. Doctors (at least those below a certain age and of a certain disposition) are eager to use it. But institutions have things like "legal departments" and are wary of things like "ethics violations" so there is resistance.
All this to say that this is a very good thing.
Mohammadreza Hojat publishes like a mad-man on his Jefferson Scale of Physician Empathy. I have never seen someone so dogged in the literature.
He's very good at describing the construct the scale measures, which is something like "how clinically important a doctor thinks patients' emotions are." This is certainly not the same as how empathetic a physician is, however.
So it's hard for me to decide whether articles like this one bug me because the conclusion oversimplifies the construct or because of professional jealousy. Hojat!
Post script: Also this one.
Work hours rules are contentious
This US News article is a bit mealy-mouthed on the impact of work hours rules for residency. I imagine someone outside and new to the debate (like a journalist) would be surprised at the vehemence on all sides. I remember I was.
There was a time when "car accident while driving home" was the number one killer of residents. The idea that (according to the above article) "Ninety-five percent of neurosurgical residency program directors, and 84 percent of chief residents, reported that a reduced workweek would 'jeopardize patient care'" is a hard trade-off.