Media Fridays - Atul Gawande on Boston hospitals after the marathon bombing

http://www.newyorker.com/online/blogs/newsdesk/2013/04/why-bostons-hospitals-were-ready.html?intcid=obinsite


I felt weird posting back-to-back Atul Gawande articles, but it's a good reminder why we put ourselves through all this. Must be something in the air. Thanks to Amit Om for the article. 

see you on the other side,

from ken

read something good? send it my way. 

Media Fridays - overwork worse than overtime?

http://well.blogs.nytimes.com/2013/04/18/doing-the-math-on-resident-work-hours/

The latest from UCLA surgeon Pauline Chen. Here's an excerpt:

"Health care trends over the last two decades have only exacerbated young doctors’ workload. Admissions to teaching hospitals increased nearly 50 percent from 1990 to 2010; in that same period, the number of doctors in training available to do the work increased by only 10 percent. And because insurers are pushing for shorter hospital stays, only the sickest patients, many of whom require complex care, remain hospitalized."

Hospital admissions increased by 50%, # of docs increased by 10%. That's a huge increase in workload. Dr. Chen's argument is that the hour work limits has not affected patient care or doctor mental health because doctors have compensated for the cut in hours with an increase in workload in those hours. 

So my question: Is the solution more doctors? More funding for residencies and less pay for attendings? Speculate away. 

see you on the other side,

from ken

enjoy sidenote in 140 characters or less @kensidenotelife.

media fridays: What MD specialty has the best job prospects?

http://www.nytimes.com/2013/03/28/health/trainees-in-radiology-and-other-specialties-see-dream-jobs-disappearing.html?_r=0

This week's article is an NYT article about the job market for doctors. We've been told it's great.. except the jobs in radiology are decreasing. Presumably, Obamacare will continue to decrease those jobs. Plus, in California nurse anesthetists are starting to replace anesthesiologists and they'll soon be out of jobs too. I was talking about this with Goran and Keith the other night as we tried to decide what residency program we should go down. So my question to y'all: what residency is most likely to continue to have high demand?

I would tend to say general practitioners, except they could seen be replace by NP's and PA's. My second guess would be surgeons because their job is so technical that nobody else could do it, even if they were legally allowed to. That said, my final answer is neurologists/psychiatrists because more and more people are being diagnosed with mental illness, and at the same time the basic science research in neuroscience is developing faster than any other field. 

Anyways, your thoughts?

see you on the other side,

from ken

read something good? send it my way. 

media fridays: Follow up to half-baked idea of 3 yr med school

http://www.nytimes.com/2012/12/24/education/nyu-and-others-offer-shorter-courses-through-medical-school.html?pagewanted=all&_r=0

If you're a fan of sidenote, you know I love the idea of shortening med school. I've written about the possibility of a competency-based curriculum where you could move at your own pace, as well as the idea of a 3 yr MD. Please read if you're interested in some background. 

So I actually did some research instead of just coming up with my own BS ideas, and I learned that NYU just started a 3 yr accelerated MD program. That's what the NYT article is about. There are similar programs at Texas Tech, Mercer University, as well as one in the works at LSU and several other med schools across the country. 

we don't believe you
you need more people

This same track could easily be done at other schools like Duke/Emory/UVA/Baylor that have the 3rd year as a research year. Why not cut that year out? We all know most med students do not like research, and there's too much wasted time in medical education. Don't you feel like you're wasting your valuable time sitting in a classroom and learning things that you know you won't ever use in the clinic? Isn't it a waste of your time cramming for Step 1, when most of that material will be outdated by the time we become doctors? Doctors ALWAYS say the material you learn in med school is out of date. 

The LCME set minimum for an MD is 130 wks of education. NYU's new program has 135. So my question to you: would you want to see this at MUSC? 

sidenote - I'm meeting with Dr. Pisano to discuss changing the MD curriculum to 3 years. I want to have some data to talk about so I set up a surveymonkey. If you're a MUSC student that is a fan of sidenote, it'd be awesome if you could help me by taking it. 

http://www.surveymonkey.com/s/5DVXK5J

see you on the other side,

from ken

read something good? send it my way. 

Media Fridays: What Makes a Medical School Great?

http://www.theatlantic.com/health/archive/2013/03/what-makes-a-medical-school-great/274403/

Like I've been saying for the past week, I've been working on evolving sidenote. The last addition I have is to Friday. I'm replacing youtube Fridays (universally unpopular) with a medicine-related article or video + a question. The first is one from The Atlantic called "What Makes a Medical School Great." I came across it in my research for yesterday's post about US News & World Report med school rankings. 

So my question to y'all: what factors are important to you in choosing a med school? Cost? Rankings? Location? Advice from friends? Culture? 

see you on the other side,

from ken

read something good? send it my way.