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Why Medical Education Should Embrace Social Media

Social Media and Medical Education: Access Denied.

-By Rebecca Hastings, D.O.

I have never been very computer or tech savvy.  I’m not up-to-date on the latest technology, but I do have a smart phone and a laptop which I use for their very basic purposes; and I do admit I have a Facebook account, mostly for keeping in touch with friends and family and, you know, the daily grind.  Up until recently, I had no idea how to “Tweet” or what Twitter was really all about.  A physician mentor of mine suggested that I start a Twitter account and take advantage of the vast amount of knowledge floating around in Twitter world.  I was hesitant at first since my free time is limited and I didn’t really need any additional distractions from my fellowship.  Plus, I definitely didn’t need to join another social media network to share pictures and read about everyone’s daily happenings.  But, I trust my mentor and appreciate his guidance, so I signed up.  And WOW!  Information overload at my fingertips!!  Within a few minutes, I became a “follower” of JAMA, Chest, Cleveland Clinic, Johns Hopkins, New England Journal of Medicine, the Annals of Internal Medicine and numerous other large medical journals and institutions.  Granted, I may have also become a “follower” of a couple fitness magazines and my beloved Kansas Jayhawks, but the majority of my Twitter thread consists of these professional organizations.  I had immediate access to hundreds of tweets from these prestigious institutions across the world.  These world-renowned entities were “tweeting” about medical information, both past and present.  They were sharing everything from major review articles to personal reflections and comic strips.  Not only were the major institutions sharing these, but other physicians were sharing their professional opinions and other articles that they found important and interesting.  By signing up for Twitter, I had opened my eyes to a whole new world of medical education.

At first, I mostly just browsed articles and topics that were posted.  But the more I read, the more I wanted to share.  I felt like others were helping me, so why not share the knowledge.   One afternoon, I sat down in the fellow call room on a break.  I had been browsing my Twitter feed on my phone and there were a couple of interesting articles and commentaries I wanted to read.  But low and behold, when signing in, a big red box comes across the screen stating “Access Denied.”  Ok, so I know Twitter is technically considered social media, but why can’t social media be used as an educational tool?  Large renowned institutions and organizations are tweeting valuable information pertaining to my livelihood and I can’t access it “on the job” where I’m supposed to be gaining an education. Continue reading “Why Medical Education Should Embrace Social Media”

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An Open Letter to Washington, D.C. From a Physician on the Front Lines.

-by Matthew Moeller M.D.

I am writing this letter because I feel that our leaders and lawmakers do not have an accurate picture of what it actually entails to become a physician today; specifically, the financial, intellectual, social, mental, and physical demands of the profession. This is an opinion that is shared amongst many of my colleagues. Because of these concerns, I would like to personally relate my own story. My story discusses what it took to mold, educate, and train a young Midwestern boy from modest roots to become an outstanding physician, who is capable of taking care of any medical issues that may plague your own family, friends, or colleagues.

I grew up in the suburbs of southeast Michigan in a middle class family.  My father is an engineer at General Motors and my mother is a Catholic school administrator in my hometown. My family worked hard and sacrificed much to enroll me in a private Catholic elementary school in a small town in Michigan.  I thought I wanted to be a doctor in 5th grade based on my love of science and the idea of wanting to help others despite no extended family members involved in medicine.  Winning a science fair project about the circulatory system in 6th grade really piqued my interest in the field. Throughout high school, I took several science courses that again reinforced my interest and enthusiasm towards the field of medicine.  I then enrolled at Saint Louis University to advance my training for a total of eight years of intense education, including undergraduate and medical school.  The goal was to prepare myself to take care of sick patients and to save the lives of others (four years of undergraduate premedical studies and four years of medical school).  After graduation from medical school at age 26, I then pursued training in Internal Medicine at the University of Michigan, which was a three year program where I learned to manage complex problems associated with internal organs, including the heart, lungs, gastrointestinal tract, kidneys and others.  I then went on to pursue an additional 3 years of specialty medical training (fellowship) in the field of gastroenterology. The completion of that program culminated 14 years of post-high school education. It was as that point, at the tender age of 32 and searching for my first job, that I could say that my career in medicine began.

Over that 14 year time period of training, I, and many others like me, made tremendous sacrifices.  Only now as I sit with my laptop in the dead of night, with the sounds of my children sleeping, can I look back and see where my journey began.

For me, it began in college, taking rigorous pre-medical courses against a large yearly burden of tuition:  $27,000 of debt yearly for 4 years.  I was one of the fortunate ones. Because I excelled in a competitive academic environment in high school and was able to maintain a position in the top tier of my class, I obtained an academic scholarship, covering 70% of this tuition.  I was fortunate to have graduated from college with “only” $25,000 in student debt. Two weeks after finishing my undergraduate education, I began medical school.  After including books, various exams that would typically cost $1000-$3000 per test, and medical school tuition, my yearly education costs amounted to $45,000 per year. Unlike most other fields of study, the demands of medical school education, with daytime classes and night time studying, make it nearly impossible to hold down an extra source of income. I spent an additional $5000 in my final year for application fees and interview travel as I sought a residency position in Internal Medicine.  After being “matched” into a residency position in Michigan, I took out yet another $10,000 loan to relocate and pay for my final expenses in medical school, as moving expenses are not paid for by training programs.

At that point, with medical school completed, I was only halfway through my journey to becoming a doctor.  I recall a moment then, sitting with a group of students in a room with a financial adviser who was saying something about how to consolidate loans. I stared meekly at numbers on  a piece of paper listing what I owed for the 2 degrees that I had earned , knowing full well that I didn’t yet have the ability to earn a dime. I didn’t know whether to cry at the number or be happy that mine was lower than most of my friends. My number was $196,000. Continue reading “An Open Letter to Washington, D.C. From a Physician on the Front Lines.”

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Why Physicians Should Learn to Pronounce Patient Names Properly

I have it on good authority that it’s not easy being green. But I’m willing to wager that it’s a whole lot easier when you have a lovable name like “Kermit”. Imagine being green (or brown) with a name like “Ramachandran”? Growing up with a name like mine certainly had its disadvantages. While most neighborhoods have a local bully who kicks ass and takes names, in my case, he would typically kick ass, but didn’t bother with the name part because he couldn’t pronounce it. Somehow I found that last part more insulting.

 I’ve long since outgrown the sensitivities about my name (although I still make any telemarketer pronounce it properly before talking with them). For most patients and those with whom I only occasionally associate, I go by “Dr. Ram”, which works fine by me. But perhaps those early experiences left me with an impression about how people can be affected in positive ways by getting the pronunciation of their name right, or at least trying to get it right. As well as the negative ways in which people can be affected by getting the pronunciation wrong, or by not even bothering to try.

So I would like to direct a message to those care providers out there with easy to pronounce names, because this  is something that you probably don’t  know. Getting the pronunciation of somebody’s name correctly (or at least trying to) is important. These people often wave you through that initial awkward part of an encounter, simply because they’ve given up hope that people are going to get it right. They tell you it does not matter only because they have already spent too much time in trying to get the name pronounced properly, only to have it reduced to a few letters. They wave away the mispronunciations because they’ve learned to accept that no one is going to invest the few seconds that it will take to pronounce it correctly. But they do care, and make no mistake, it is very important to them. Not taking the time to learn the pronunciation of someone’s name sends a powerful message. It says “We don’t know you, you’re a stranger here” And doing it repeatedly says “I still don’t know you, and I’m too busy to bother to try”. The subconscious message that the patient takes from these encounters is “these people don’t know who I am”. Conversely, taking the time to try to learn the proper pronunciation of a name  says “I’m listening to you” and “I want to know who you are”. Continue reading “Why Physicians Should Learn to Pronounce Patient Names Properly”

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Sandy Hook Elementary, Where I Chipped My Tooth on the Jungle Gym.

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Sandy Hook Elementary school will always be the place were I chipped my tooth on the jungle gym, the place with huge skylights in the ceilings, wide curving hallways filled with happy children and wonderful teachers. The firehouse was the place where parties and receptions were held. My heartbreaks for my Newtown. Be at peace children.

Written by my  brother, Ajith Ramachandran, who attended Sandy Hook Elementary School. We all grew up in Newtown, CT, where my mother still lives. It is a beautiful small town filled with wonderful memories for us. I attended St. Rose elementary school a few miles up route 6. I always remember Newtown as a safe place where people looked out for each other, but maybe that’s just nostalgia. As children we rode our bicycles all over town. The streets were narrow and hilly, meandering through thickly forested  land. In the summer it was dense forest filled with creeks and thick brush. Winters brought snow covered hills that were great for sledding. For a child, it was a wonderland waiting to be explored. The firehouse at Sandy Hook Elementary was a common meeting place to host functions, and my favorite was spaghetti dinners to raise money for kids activities. Nowadays I still look forward to bringing my kids back to Newtown to visit grandma and see a part of nature that they would otherwise never experience living in a suburban subdivision. A part of me will always be in Newtown, and it will always be home.

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Hospital Names New Executive Vice President in Charge of Lobby Christmas Tree.

An Announcement from The Holy Profit Medical Center.

“Holy Profit Medical Center” is a series of fake satirical press releases and news articles from an imaginary hospital. . . 

The Holy Profit Medical Center today named Bess E. Morass to the new post of Executive Vice President in Charge of Lobby Christmas Tree.

“We are very excited to have Bess here”, said HPMC CEO Haywood Jabuzov. “Ms. Morass received her MBA from Northwestern Michigan University, which is nationally recognized as being slightly better than Southwestern Michigan University.”

“We are very excited about this years lobby Christmas tree project” said Ms. Morass. “We have a very imposing task ahead of us, and it all begins with the Strategic Christmas Vision Project, which has already formed a committee. In those meetings we have given several power point presentations on how we might go about forming subcommittees to tackle the number of challenges that we are likely to face. We have already identified a number of areas where we may acheive strategic synergy, particularly in collaboration with the Task Force on The Formation of The Christmas Tree Decoration Committee.

Also at issue this year, is the very expensive lighting and extremely bright star on the top of the tree. Last year many patients complained that the light was so bright that it was keeping them up at night. Many employees are also questioning the cost of the tree in light of the many recent cut backs at the hospital. “This is an important point. It is the very reason we are proceeding with the Strategic Christmas Vision Project, after all, when people are laid off or are sick in the hospital, it’s more improtant that ever to have Christmas spirit!” She added, “however, the decision on the star is not under my purview, and will need to go through the ESCCTS (Executive Sub-Committee on Christmas Tree Star). We expect to have a decision on that by July of next year.”

“The first issue on our agenda was the color of the tree,” said Mr. Morass ”and I am pleased to report that we have decided to go with a yellow tree this year to promote gall bladder sludge awareness.” The Lobby Christmas Tree will be on display until mid-January, after which the Committee on Lobby Christmas Tree Disassembly will be tasked with its removal.

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Top 10 Advances in Medicine (1-5)

As promised, here’s the conclusion of my list of the Top 10 advances in medicine.  As stated before, here are the ground rules: I’m not ranking surgical advances,  I’m sticking to American medical problems, and we’re not including public health initiatives like clean drinking water. No, what we have here is a rare tribute to our  much maligned pharmaceutical industry in all its capitalistic chemical glory.
So once again, without further delay or  pre-authorization, here’s the cream of the crop of the top 10 medical advances.

5. Antihypertensives. Hypertension, like diabetes is a common contributor to vascular disease which lead to, among other things, stroke and coronary artery disease. The greater control of blood pressure by these medications has undoubtedly contributed to a reduction in morbidity. In addition, medications like angiotensin converting enzyme inhibitors and beta-blockers have other beneficial effects that go beyond their blood pressure lowering effects.

4. Birth control. In olden times in this country, and in many parts of the world today, it has been financially advantageous to have children. In an agrarian world, children contribute to labor, and tend to their parents as they age. Marriage of children could also mean merging of families and greater wealth. Nowadays, it costs close to $300,000 to raise a child. In addition, fewer children has meant more women in the job force and reduced strain on people, and marriages, which make for healthier people. Fewer children also means more resources for each child, which make for healthier children.

3. Insulin and other hypoglycemic agents: Diabetes is a major contributor to disease in the world. While it only ranks as the number 7 cause of death in the U.S. it is being increasingly understood that even minor amounts of hyperglycemia can contribute to vascular disease, particularly heart disease and stroke (which rank as the first and fourth most common causes of death). Undoubtedly without these treatments the incidence of vascular disease and infection would be astronomically higher.

2. Anesthetics and Pain medication. Imagine a world in which only the most basic surgical  procedures could be performed. A world where even lancing a boil would be considered barbaric and avoided at all costs. That’s what the world was like in the dark age before anesthesia and pain medicines. So many things that we take for granted in today’s medical world, like medicines for a minor procedure or obstetrical deliveries would not be possible without anesthetic agents. And that’s before we even consider things like hip repairs, open heart surgeries, and appendectomies. No, I think I would rather not try to imagine that world.

1. Antibiotics. Ok, this was an easy one, even most kids know about the invention of the first antibiotic. I shudder to think of where we would be today without the father of modern medicine, Dr. Penicillin, whose incredible legacy is today carried on by his grandson, Dr. Vancomycin. I kid. Check out this fascinating  first-hand account of the first use of penicillin in the U.S.; a 33 year old woman at Yale, New Haven hospital. A single vial of the “black magic” was shipped from England, the physicians actually collected the patients urine to reclaim the drug and re-administer it. She lived to the age of 90. Awesome stuff.

Check out the CDC’s list of the top 10 public health achievements of the previous decade. I found the statistics on the benefits of vaccines of particular interest; “A recent economic analysis indicated that vaccination of each U.S. birth cohort with the current childhood immunization schedule prevents approximately 42,000 deaths and 20 million cases of disease, with net savings of nearly $14 billion in direct costs and $69 billion in total societal costs.”

Related Articles: Top 10 Medical Advances (6-10);   Top 5 Things No One Taught Me in Training;   Top 5 Things You Don’t Know About Your Doctor;  Top 5 OTC Meds That Would Require  Prescription if Released Today.

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Top 10 Advances in Medicine (6-10)

I’ve been thinking lately about all the great advances in medicine over the years. There have been lots of them. And despite everything you’ve heard about looming cuts in healthcare, I have no doubt that the hits will keep on coming. Since I seem to be on this Top 5 thing lately, I figured I would continue this ride and rank my top 10 medical advances over the years. There had to be a few ground rules before putting together a list like this. I’m a medical doctor ranking medical therapies, and so surgical advances can take up space on someone else’s server. And just to be clear,  since it’s been awhile since I’ve treated malaria and cholera, I’m going to stick to western world problems and western world drugs.  I’m also not the young idealist I once was, so public policy initiatives, like seat belts, clean drinking water, and vaccinated babies are being tossed out with the bathwater. No, we’re talking about good old fashioned chemicals with long complicated names produced in soot belching factories and administered in our nations pharmacies and hospitals with epic markups to ensure future stock gains research funding.
So without further delay, and with no pre-authorization required, here is the latter half of the top 10 medical advances.

10. Psychiatric Meds. One has only to look at the CDC’s list of the top causes of mortality in America to see the logic behind this choice, as suicide rounds out the top 10 causes of death. But psychiatric problems also have a much greater impact beyond suicide. Problems like depression and anxiety often exacerbate other medical conditions, increasing the risk of complications.  They put strain on family members and cause lost productivity and income. They are one of the most common reasons for enrollment in disability. Continue reading “Top 10 Advances in Medicine (6-10)”

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I’m Tired Of. . .

It’s been a long few months. What with the recent death of a family member, the usual barrage at work, and trying to raise a family, I think I may be in the early stages of physician burnout. So I’m going to give myself liberty to do something I rarely do. . . I’m gonna complain. Oh yeah, I’m gonna gripe and whine, and cry like a little baby. Just this once. But don’t worry about me.  Because as you read this I’m sitting in a meditative cleansing trance, taking in beautiful scenery, and trust me,  it feels oh so good. So I’ll be back soon, batteries recharged, taking all the things I’m griping about here with a swing in my step and a smile on my face. Continue reading “I’m Tired Of. . .”