Medical School as a Reflective Community

By Mark Kuczewski, Katherine Wasson, Kayhan Parsi, and Emily Anderson

Judging from coverage in the literature lately, reflection as an educational tool is becoming increasingly popular in medical school. But instructors use reflection for lots of different reasons. In a recent article, we described how we use reflection in the formal curriculum and in two co-curricular programs at Loyola University Chicago Stritch School of Medicine.

Reflection permeates, even saturates, the curriculum here. It aligns neatly with the school’s culture and reinforces it. As we create a community of learners engaged in reflection, it raises a number of opportunities and challenges for our future work. Continue reading Medical School as a Reflective Community

My Week as a Country Doctor

By Ulfat Shaikh, MD

Originally posted June 22, 2015

Just got done with a week as camp doctor at a resident camp for children in Central California. I started volunteering as camp doc last summer, not just so I could clandestinely keep an eye on my own kids and take their pictures on the sly — but as a personal challenge to see if I could do one of the most challenging yet rewarding jobs in medicine, being a country doctor.

Continue reading My Week as a Country Doctor

Health Wonk Review: Hot Summer Nights, Cool Summer Drinks

Originally posted July 16, 2015

By Hank Stern

Good morning, fellow Wonkers and Wonkettes, and welcome to the midsummer collection of refreshing blog posts. And now to quench our thirst for knowledge (amongst other things):

■ Joe Paduda, HWR co-founder and all-around nice guy, believes that there is no “Obamacare,” and offers some clarification about what PPACA is, and isn’t.

■ Our good friend Louise Norris reports on the Centennial State’s health insurance rate environment. She notes that, as always, “premium is king,” but that that’s always been the case. So what’s different now? Click through to find out.

By the way: When you get there, be sure to congratulate hubby Jay on his recent appointment to the Connect for Health Colorado board of directors. Mazel Tov, Jay!

■ Over at The Hospital Leader, Brad Flansbaum tells us about “super-utilizers,” folks who consume a disproportionate amount of health care, and what this means for the rest of us “normal” folks.

■ Jaan Siderov has always been one of my very favorite bloggers in this corner of the blogosphere, and his submission this week further cements that: we’ve all heard concern about the various carrier mergers; Jaan offers his own take, with some currently-under-the-radar concerns.

■ As usual, David Harlow casts an outsized shadow with his unique insights into something that, at first glance, seems so simple: patient reviews of their docs. David asks a simple question (“Where are the metrics to guide rational choice of provider?“) and then dives right in.

■ Uber-wonk Roy Poses takes to task former President WJ Clinton for touting a liver pill (no, not this one) that costs $1,000 a pop, yet shows little evidence of actually, you know, working very well.

■ Jason Shafrin, my favorite Health Care Economist, also asks a question: “What is the key driver of regional variation in the cost of treating patients with cancer?” Think you know? Well, then, click on through to check your knowledge.

■ The Health Affairs Blog sends along this post by Donald Light on the risks versus rewards of certain FDA-approved meds, and notes an “epidemic of harm from medications [that] makes our prescription drugs the fourth leading cause of death in the United States.” Talk about the cure being worse than the disease!

■ Another good friend, David Williams, wrestles with the conundrum [ed: what a great use of that term in this context] that capping insured patients’ specialty drug co-pays may actually do more financial harm than good, in the form of higher prices.

■ Workers Comp maven Tom Lynch has his sights on the alarming fact that injury rates for home health and personal aides is two-and-a-half times that of other workers, and that OSHA’s really failing these folks.

■ Long time HWR contributor Peggy Salvatore introduces us to the 21st Century Cures Act. Overall, she likes it, but is puzzled by the fact that its proposed funding mechanism is revenue not from Big Pharma and the NIH, but the oil industry. That’s not necessarily a bad thing, but she wonders why the health care sector is turning to the energy sector for cash.

■ The folks at offer a post from Amy Lynn Smith extolling the virtues of the ACA as it relates to the LGBT community.

■ To finish up, I’m going to exercise Host’s Privilege and tout this two-parter from my co-blogger Mike Feehan. We spend a lot of time at IB correcting folks who conflate health care with health insurance, but Mike tackles new ground in his posts: despite popular usage, health care and medical care are not the same.

Mike makes a compelling case. Click here for Part 1, and here for Part 2.

Well, that’s it for this week. Hope you enjoyed the good reads and tasty concoctions. Don’t forget to drop by PeggySalvatore’s place on August 20th for the next edition.

Improving Patient Care as a Trainee

Originally posted July 14, 2015

By Monica Shah

Patient safety has always been a priority for me, but it is only recently that I became aware of the many issues that threaten quality of care for patients. As a medical student, I vividly remember shadowing at the hospital and being shocked at what I saw. I walked through patient rooms and heard loud beeps going off, the constant chatter of hospital staff, and the automatic entrance into patients’ rooms without even a knock. I wondered whether all of the disruptions and commotion impacted patient recovery in the hospital and after discharge. After pondering this, I decided that I wanted to take action and see what I, as a medical student, could do to improve daily inpatient conditions. Continue reading Improving Patient Care as a Trainee

What Academic Medical Centers Can Learn from Lippi

By James McDeavitt, MD

Originally posted July 7, 2015

512px-fra_filippo_lippi_-_madonna_with_the_child_and_two_angels_-_wga13307What does this 15th century Renaissance painting have to do with a 21st century academic medical center?

Painted by Fra’ Filippo Lippi (a monk of some questionable repute) in about 1465, I selected this image as an analogy for our two broad challenges in building a successful academic medical enterprise in the rapidly changing healthcare environment.

The first challenge is the need to innovate.

At first blush, Lippi’s Madonna With Child and Two Angels may not scream innovation. However, in its time it included a number of groundbreaking techniques. Continue reading What Academic Medical Centers Can Learn from Lippi

UAB Medicine Issues Innovation Challenges to Frontline Employees

By Jennifer J. Salopek

socialized_medicineWith more than 5,000 employees, the folks at UAB Medicine knew that there were good ideas out there. But how to uncover them? Melissa Mancini, director of strategy and business development, wanted to engage frontline employees on a social platform along the lines of what she had seen at Dell and Starbucks. The foundation was firm: UAB Medicine had established a formal innovation program three years before, with such features as a solid infrastructure, an innovation board—even an internal venture capital fund, which makes small ($5,000-$10,000) proof-of-concept grants to employees who submit worthy ideas. Partnering with consulting firm Imaginatik, Mancini and her team issued the first innovation challenge to employees in June 2014: “How can we improve the patient experience and daily efficiency?” Continue reading UAB Medicine Issues Innovation Challenges to Frontline Employees

Writers Call on Public Sector to Establish National Innovations Database

Latest post in the series arising from our partnership with Healthcare: The Journal of Delivery Science and Innovation. Read more about the partnership here.

???????????????????By Jennifer J. Salopek

Could a national database, populated with descriptions of innovative initiatives and their results, help to accelerate the pace of change in health care delivery reform? A trio of authors, writing in Healthcare: The Journal of Delivery Science and Innovation, thinks so, and lays out their proposed model in their March 2015 article, “Crowd-sourcing delivery system innovation: A public–private solution.” Wing of Zock spoke recently with corresponding author Craig Tanio, MD.

Continue reading Writers Call on Public Sector to Establish National Innovations Database

“Why Do You Tweet, Anyway?” A Glance Into #MedEd Tweeting

Originally posted to AM Rounds on June 11, 2015

By Alireza Jalali, MD, Andrew Micieli, MMI, and Jason R. Frank, MD

socialized_medicineA common question asked of many medical educators seen tweeting in the wild is “Why do you tweet?” There are a few main reasons why Twitter is such a popular tool among medical educators, including: advocacy, teaching, immersion, and professional networking.

For a physician, Twitter is a great place for health advocacy and education of the general public. It can be used as a platform for discussing medical issues (e.g., vaccination), debating, and gathering public opinions. It can provide a transparent platform to advocate for a public cause directed at politicians, industry leaders, or pharmaceutical companies. It can also be used to facilitate connecting with others who have similar interests, promote one’s area of expertise, and find other researchers to discuss research plans, network, etc. In this way, physicians like Michael Evans have an enormous worldwide public impact. Continue reading “Why Do You Tweet, Anyway?” A Glance Into #MedEd Tweeting