Happy Memorial Day!

The Medical Student Learning blog will be taking the week off in honor of Memorial Day. Come back next week when we resume our regular Monday / Wednesday / Friday schedule.

Medical Schools Are Blogging

The push to incorporate more social media into medical school learning has also included the use of blogging among medical schools and teaching hospitals. This is an area that the AAMC looked into more closely in a recent article, detailing how this avenue of outreach can help others learn and become more aware of the medical information around them.

Medical schools can maintain different topical blogs in order to connect to certain audiences without having to combine messages for a broad spectrum of backgrounds. This allows medical schools to break down complex topics into more personal stories. This also leads to patients becoming more involved with the topic and seeking an increase in their personal knowledge.

“We have had cases where a physician will call or e-mail us and say a patient came in with one of our blog posts printed out in their hand. When that happens, we know the blog is effective. It’s just a different voice from the other ways we communicate.” ~ Jason Merrill, Maintainer of the Touching Base blog (BJC Healthcare's Barnes-Jewish Hospital)

The use of blogs opens the conversation potential not only among patients, but also medical professionals themselves. Students and physicians can contribute to the discussion through outlets that they are not afforded in traditional media. Through these conversations, a greater understanding of the topic may occur and could lead to a wider contribution in the national discussion. It is through these opportunities that understanding among patients and physicians can increase and the medical industry can benefit from the new avenues of knowledge that are emerging.

On-The-Go May Mean Patient Endangerment

The push for mobile technology has allowed physicians to be more mobile in terms of treating, learning, and patient interaction. However, some of this mobility may put patients at risk because lack of attention to detail. That's an issue that Spire Healthcare looked into recently.

Brigham and Women's Hospital researchers looked into the topic of physician dictation. Doctors often dictate their notes for patient files, yet in doing so they may be overlooking relevant data. When physicians do not consult medical records when dictating, they are likely to forget pertinent medical information and may misdiagnose or diagnose with conflicting treatment.

"Doctors who dictate may not be paying as close attention to information and alerts in the electronic health record that are important for patient health." ~ Jeffrey Linder, Associate Professor of Medicine (BWH and Harvard Medical School)

When working through patient files, recording information from visits as well as findings, physicians should consult the available health records to make sure nothing is overlooked. It's possible that this contributing information will change the diagnosis or open the door to possible other avenues of treatment. Always utilize all resources that are available, else the patient may suffer.

Mobile Technology in Medical School

The use of mobile technology is growing in both medical schools and the population at large. With this inclusion, many medical schools are finding new ways to integrate the technology into their curriculum. US News took a look at this push in a recent article.

Mobile technology has allowed better access between patients and physicians. Medical professionals can share medical information more freely, educating patients about symptoms or illnesses. Schools are beginning to integrate this educational ability into their offerings. Johns Hopkins University's School of Public Health and Harvard Medical School are both researching how mobile technology can be used in under-served areas, bringing medical information to those who may not have convenient access to medicine.

In the medical schools themselves, students are gaining exposure to the technology earlier and earlier. They can receive their books or hand-outs via mobile devices rather than printed. This eases the impact on printing costs, but also allows students to carry around the information more easily. Harvard has looked into patient tracking integration for their students. Third year medical students can track their interactions with patients and faculty can review them without having to track down paperwork.

The bottom line is the ease of use that mobile technology allows. By opening the potential for education, mobile technology has allowed better educational opportunities for patients and physicians. Tools to make medicine easier and more stream-lined are always welcomed and mobile technology is doing just that.

New App For Current Research Reading

Medical research is ever-changing and it is hard for practicing physicians to keep track. However, a couple of Stanford University students have sought to ease this strain with a new iPhone app. Developed by two medical residents, Dr. Dave Iberri and Dr. Manuel Lam, Journal Club for iPhone summarizes current research so that physicians, medical students, and other health professionals can access and learn while on the go. The app allows you to sort trial data by specialty, disease, name, or date so that you can get the information needed without having to sort through the research you don't.

"Written by physicians, these article summaries are distilled into bite-size morsels that clinicians can digest quickly. Think of it as CliffsNotes for medical research." ~  Dave Iberri , MD

The app has been developed with the contributory community in mind. When first in development, attendings and fellows at Stanford were asked to list landmark trials so that a list could be made and more research done to start the information database. Then clinicians helped write up the summaries necessary to condense the trial information into more manageable sizes. The same approach was used when beta testing the app, as the designers received feedback from a number of people in order to improve functionality and versatility. They will continue to listen to user feedback as subsequent releases are made for the app. With this community health tool in place, physicians and other health professionals can be better informed on what current research shows and, in turn, can use that knowledge to improve patient health.

Integrating Social Media Into Medicine

With the increase in social media and its integration into the population's internet usage, it stands to reason that medical professionals would be utilizing the technology as well. However, just as there are benefits to using social media to educate and communicate, there are also possible downsides, too. That's what The Cyprus Times looked into with their latest article on the subject.

First of all, social media can help to provide better information and medical education. Patients can discuss their diagnosis among each other, sharing common outcomes and asking questions about possible problems. This puts them in a better place to ask questions of their medical provider as well, since they'll be better informed. Physicians can also utilize this technology to educate the patient population at large, sharing scientific findings and general knowledge about medical subjects. Being better informed helps both the patient and physician.

Having physicians and patients both on social media can help to increase the interaction the two have with one another. Patients can ask general health questions without having to schedule an appointment, physicians can arrange office visits through the internet instead of tying up staff time, and fellow patients can recommend or warn against certain physicians that they've had prior experience with. This creates a larger and more informed discussion for all involved.

Just as the possibility of open discussion exists, so too does the possibility of compromised anonymity. Physicians should be aware of how much information they're putting online about themselves, but also about their patients. If too much identifying information is included in sample cases, others will be able to decipher just who is being talked about. It's important that patient confidentiality be maintained, so education should not come at the cost of exposure.

With the proper use of the tools provided, the medical community can become better, more informed participants in the overall strengthening of healthcare. Patients and physicians should have open lines of communication and education should be able to flow freely. Being better informed is a positive goal for everyone.

Learning Diversity in Medicine

When training to be a physician, it's important to learn about patient diversity. You will often be tasked with explaining medical procedures to people who might not have the same background or knowledge as you, so you will need to know how to educate and understand the population at large. This can be made harder or easier, depending on where you choose to go to medical school.

The population diversity of North Dakota is going to be vastly different than the population diversity of New York. If you are training and planning to work in the same general area, that might not be a problem, but the experiences from medical school might not translate well to another geographic location. However, you can take steps in order to ensure that you have the background necessary to work in a variety of locations and with a variety of patients.

1. Take Language Classes: You might only know English, your patient might only know Spanish. This is a problem that can be solved with extra education. Look into taking foreign language classes, learning dominant languages that are present in both the local geography and the wider United States. If you are planning to move to an area that has another dominant language, prepare yourself beforehand.

2. Research The Areas: Look at the cultural diversity of the medical schools you're considering. Will they prepare you for your larger career? Can they offer the education necessary to understand the variety of patients you'll encounter? And look at the areas you're planning to move to when you go into practice. Are you prepared for the diversity of patients you'll be treating? If not, are there educational opportunities to fill the gap in your knowledge?

If you are more prepared for the patients you'll be treating, you can provide a better medical experience for all involved. Don't let a cultural barrier negatively impact your ability to treat patients. Train yourself, seek out new educational opportunities, and immerse yourself in the geographic area you're in. It will be a beneficial experience.

Medication Adherence

Prescribing medication for illnesses is a common practice. However, getting patients to follow through and take all their medications is often difficult. Patients may start feeling better a few days into treatment, so they simply forego finishing their prescription. Or maybe they don't like the side effects the medicine causes, they fear becoming dependent, or their schedule doesn't allow for proper adherence. Whatever the case, 75% of patients do not take medication as prescribed. This causes issues in terms of built-up immunity to the medication, a mutation of the illness so that stronger medication must be used in order to treat, and even 125,000 annual deaths.

In order to help with this issue, PillJogger is now available. Through the use of the FICO Medication Adherence Score, the company can identify patients that are more likely not to adhere to medication schedules. By using this information, patients can receive communication and reminders in the form of emails, letters, or phone calls to encourage medication adherence. This brings in the human touch and will increase the likelihood that patients will follow through with proper treatment.

By combining available technology, the medical industry can make sure that patients receive the best care possible and that their health outcomes are improved over current rates. By making it a team effort, everyone can benefit.

Enrollment Rising, But What About Residency?

With the increased need for physicians, medical schools are trying to up their numbers by increasing enrollment. This has been overall successful, as schools are on track to increase their overall enrollment the 30% it needs by 2016, which will take care of the expected physician gap. However, while medical school enrollment is on the rise, the number of residency positions are not keeping up. This causes a stopping point in the push to have more physicians enter the workforce.

“U.S. medical schools are doing all they can to address a serious future physician shortage in this country. We are pleased to see that enrollment continues to grow, both through the expansion of existing medical schools and the establishment of new ones. But this won’t amount to a single new doctor in practice without an expansion of residency positions.” ~ Darrell G. Kirch, MD, AAMC President and CEO

In order to increase the residency positions across the country, and allow for more training of physicians-to-be, there needs to be an increase in the number of instructors available. Students cannot be trained if there is no one to train them. Residency opportunities need to expand in order to keep up with the demand. By opening up the areas in which medical students can take their residency, it will also open up the number of new physicians that can enter the marketplace and help with the increased patient demand that will come with the changes in healthcare. By working together, the population can be assured of having well-trained physicians taking care of them.

Unconscious Racial Bias

Equality in treatment is something that all physicians should strive for. Physicians must learn to treat all patients without personal bias, equally and fairly. However, studies have shown that doctors still may hold unconscious racial bias towards their patients, which in turn negatively impacts their care.

In a recent study, published in the American Journal of Public Health, researchers found that as many as 2/3rds of physicians have an unconscious racial bias towards patients. These physicians will dominate conversations so that the African American patient has less input, give patients less control over medical decision making, and not take patients' needs into account when treating. This creates a ripple effect for patients so that there is lack of trust between the patient and physician, as well as less likelihood that the physician will be recommended to others.

"If patients have good patient-centered interactions with their doctors, we know they're more likely to follow through with care, make follow-up appointments and better control diseases such as diabetes and depression. This study suggests that unconscious racial attitudes may be standing in the way of positive interactions to the detriment of patient health." ~  Lisa A. Cooper, M.D., M.P.H., Professor (Division of General Internal Medicine, Johns Hopkins University School of Medicine)

How can the medical community counteract these biases and make sure patients receive the same level of care? It will take time and consideration. Unconscious bias exists because of a lack of awareness that it is taking place. Physicians should try to evaluate their opinions of patients and why they have made these assumptions. Has the patient said or done anything to indicate that they will be less than forthcoming in complying to treatment? From a patient's perspective, they should feel comfortable calling out physicians when they feel they're not getting the best care possible. Once physicians are aware of their bias, they can make moves to change their approach. The goal is to make medicine a team effort, where all participants feel good about what's occurring.