Balancing the Ethical with the Financial in Medical Research Funding

By Philip A. Cola

The United States government allocates billions of dollars annually to training physician scientists and funding medical research. But what are the ethical and motivational considerations of the scientific knowledge transfer necessary to advance the clinical practice of medicine, known as translational medicine? Naturally, when we or a family member gets sick, we want the best-trained physician scientists and the most advanced treatments available. Indeed, there is a greater need for health care services and dissemination of scientific discovery than ever before. Unfortunately, the outcomes of these studies come at an unusually heavy societal cost.

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Posted in Human Capital/Management, Leadership, Research | 1 Comment

Public Health and the Freshman Fifteen

By Christine Hunter, MD

For many young adults, the college “freshman fifteen” marks the beginning of a lifelong struggle to balance calorie intake with activity level. Long days of studying are punctuated by trips to the dining hall to socialize over well-stocked buffets. Academic commitments, along with work or community service, leave little time for recreation. Left unchecked, weight gain is inevitable, and these young adults will enter the health system as the next generation of diabetics and hypertensives.

To reverse this trend, colleges often take the important steps of serving healthy entrees, displaying nutrition information, and providing ample fresh fruit and vegetables. Standout institutions encourage every student to participate in athletics—offering inviting gym facilities and a diverse array of intramural sports. On a recent trip to Boston University, I was struck by the lean builds of the student body—nary a “beer belly” or “muffin top” in sight. University leaders shared insights into their remarkable success, agreeing on three extra steps that earned them a spot among the “Top 25 Healthiest Colleges in the United States:”

On-campus living. Because Boston real estate is expensive and parking scarce, the University president and medical campus provost led an initiative to provide more housing in attractive residence halls on campus. Without commutes from remote apartments, students get time back in their days for recreational sports or personal exercise.

Public transportation rate changes. For many years, BU students could ride Boston’s Green Line streetcars from one end of the Commonwealth Avenue campus to the other without charge. When the transit authority’s financial circumstances ended this privilege, BU turned adversity into advantage. Students literally “took to the streets,” adapting their routines to walk or bike between classes. Boston’s new Hubway rental bikes provide a handy alternative.

Going trayless. This was the crowning move. Concerned about sustainability, staff and students sought to eliminate wasted food along with the water, energy, and chemicals used for tray washing. A campus-wide initiative to “go trayless” paid unexpected dividends as students selected only what they could carry—and consumed fewer calories in the process!

Medical schools should jump on the bandwagon to encourage adoption of similar strategies to prevent untimely deaths from heart disease, stroke, and complications of diabetes. In fact, BU School of Medicine Dean Karen Antman notes that medical schools “have a responsibility to lead; promoting lifelong habits that translate into health and longevity.”  Health care and medical education have long been criticized for teaching only about disease treatment and ignoring the importance of prevention. We acknowledge that the curriculum crunch leaves little room in formal didactic training…but there is a great informal environmental training opportunity here.  We can begin the discussion about how personal health connects to population and public health.

The resources are readily available. The Practical Playbook is an online repository of tools, resources and case studies that explain what happens when primary care and public health work in concert.  State by state public health metrics that reflect nutrition and daily activity are available from the CDC.

What are we waiting for?  Small changes add up to a big impact, and the Healthy Campus 2020 Initiative offers additional tips on how to get started. Whether by embedding more physical activity into daily routines or going trayless to reduce calorie consumption, and getting serious about measuring our impact, we can all lead by example.  Let’s lay the groundwork now for a healthier class of 2015!

Hunter_ChristineChristine Hunter (Christine.hunter@outlook.com) is Chief Medical Officer at the U.S. Office of Personnel Management where she oversees health care quality for Federal employees and their families.  Dr. Hunter is a retired Navy Rear Admiral with over 30 years of experience in Federal health care.   She serves on the Boston University Board of Overseers.

The views expressed in this post are those of the author and do not necessarily represent the views of the Office of Personnel Management or the United States Government.

Posted in Population Health, Primary Care | 1 Comment

Happy Match Day from Wing of Zock and The Health Scout

Match Day cartoon - Munves

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Restorative Justice to Resolve Learner and Differential Mistreatment

By David Acosta, MD, FAAFP, and Paul G. Cunningham, MD, FACS

Hospital behaviors that may have been tolerated in the past are clearly viewed differently now, and can no longer be accepted in the future. Any form of mistreatment negatively affects the culture and climate of medical schools and teaching hospitals.

The Association of American Medical Colleges (AAMC) Council of Deans and the leadership of our academic medical institutions have placed a high priority on eliminating all forms of mistreatment toward students during medical education, emphasizing that students need to learn in a supportive environment.

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Posted in Commentary, Diversity, Leadership, Medical Education | Leave a comment

Interview Practice, Informatics Improve Match Odds

By Marlene Welch, MD

One year ago, when I wrote my first Wing of Zock post, “Matching the Unmatched: The Role of the Medical School Career Advisor,” I never expected that it would be the second most popular of 2013. Obviously, the fate of the unmatched student is on the minds of many of us in academic medicine. In that post, I outlined some proactive strategies used by medical student career advisors, including identification of “at risk” students, data-driven advising to reverse the mismatch of the less competitive applicant and highly competitive specialties, and the use of alternative plans and back-up plans. Plans for students who did not match included delaying graduation, entering graduate programs such as MBA and MPH programs, and identifying research fellowship opportunities.

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Posted in Medical Education | Leave a comment

Start Early to Turn Medical Students into Latino Health Advocates

By Orlando Sola, Amelia MacIntyre, Bryce Spitze, and Ankeeta Mehta

Minority populations historically have faced significant obstacles in accessing health care. Over the past six years, health care reform has dominated the attention of American politicians, yet Latino communities continue to struggle to receive the resources necessary to address their medical needs. Data from the CDC shows that the U.S. Latino population is disproportionately affected by obesity, HIV/AIDS, preventable hospitalization, and teen pregnancy. To ensure that the interest of Latino and other marginalized populations are met within current health care reform, underserved populations require leaders whose expertise extends beyond clinical acumen.

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Posted in Commentary, Diversity, Medical Education | Leave a comment

A New Beginning for Academic Medicine

By Joanne Conroy, MD

13-194 HCA Publication CoverLast week, the AAMC, in partnership with Manatt Health Solutions, released a seminal new report: “Advancing the Academic Health System of the Future.” In it, we reported on the activities of the Advisory Panel on Health Care for the past year: 13 academic medical centers (AMCs), selected for their reputation as thought leaders, were interviewed and studied in depth. These interviews revealed several shared characteristics—perhaps secrets to their success?—and the concrete steps they are taking to ensure continued financial sustainability and support of their education and research missions.

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Posted in Future of AMCs, Leadership | 2 Comments

Curating Content via Social Media: A New Role for Physicians

socialized_medicineBy Matt Hawkins, MD

Social media in health care is all the rage. Set up a Twitter account, get a Facebook page—heck, even start a Pinterest account for your office or group. Mix it together with a little video content, SEO, and a flashy URL, and you may be able to find some ROI from your social media efforts. It’s modern. It sounds complicated and advanced. And many social media experts who are dabbling in health care are pushing the merit and success of this marketing strategy.

But should this be the role social media plays in a physician practice? Should hospitals use Twitter as a digital billboard with viral potential? Marketing is important, but is it appropriate for physicians who are entering the social media space?

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Posted in Patient Engagement, Socialized Medicine | 3 Comments

“Practical Playbook” Initiative Heralds A New Era for Population Health

By Jennifer J. Salopek

A new initiative being launched today will usher in a new era for population health, whose progress historically has been stymied by multiple stakeholders who don’t communicate, using a variety of unvalidated models. This initiative, A Practical Playbook: Public Health and Primary Care Together, centers on an interactive tool that navigates users through the stages of integrated population health improvement. The initiative was developed by the de Beaumont Foundation, Duke Community and Family Medicine, and the Centers for Disease Control and Prevention.

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Posted in Care Delivery Innovations, Medical Education, Population Health, Primary Care | 2 Comments

Innovative Undergrad Course at Rice: Applying Design Thinking to Health Care Problems

First in a series

By Jennifer J. Salopek

Three weeks ago, at a restaurant in Houston, the solution to a major health care problem may have germinated. Around a table were gathered Michael Fisch, MD, chair of the Department of General Oncology at the University of Texas MD Anderson Cancer Center, and four undergraduates who are enrolled in ENGL 386 at Rice University. The goal? To figure out how to use digital innovation and technology to encourage adult cancer patients to enroll in clinical trials.

Much about this equation may seem unlikely: Department chair + Undergrads + English course = Improved cancer research? But indeed, that is the hope.

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Posted in Health Care Innovation, Medical Education, Patient Engagement, Socialized Medicine, Technology | 1 Comment