Saturday, September 24, 2011

Three trends on the future of the medical profession, with links.

Ruminations on a profession:
Kent Bottles (@kentbottles) has a great piece:The Effect of the Information Revolution on American Medical Schools. It's a bit dated, but his opening comments on the nature of the medical professoin are golden.

Trend 1: Explosion of information tech and its consequences for medicine.
A GREAT 18 minute TEDtalk by Daniel Kraft: Medicine's Future? There's an app for that. (It's about leveraging cross-disciplinary, exponentially growing, technologies.)

Another fascinating TEDTalk by Eric Topol: The Wireless Future of Medicine. Many of these topics are covered in the Kraft talk, but it offers a wider survey of the gadgets.

Trend 2: Disruptive innovate is coming. 
The bible on this topic is The Innovator's Prescription by Clayton Christensen and others. Disruptive Innovation in Health Care Delivery provides a synopsis of the major concepts. (This one might be a little painful- hang in there through the business model talk- t's worth it.)

Trend 3: Social Media is coming.
Clay Shirky is the guru of social media (a philosopher and a sociologist). He has two TEDTalks, the first is about group formation and action. It's from 2005 and not specifically about healthcare, but it doesn't take a lot of imagination to apply it to healthcare. The second is more about information streams, and the same goes. Specifically, he details the power of groups to usurp professionals.

If you have the time, Shirky's newest book Here Comes Everybody is a great, great read.

Of course, feel free to explore your own topics and content- these are just some suggested guidelines. 

I'm excited for this session! Of course, let me know if you have questions.

Until then,

Sunday, September 4, 2011

Protecting institutions from medical students

It may be helpful to sort policy goals for students into three categories:

1- How to protect patients.
2- How to protect institutions.
3- How to protect students themselves.

This post addresses protecting institutions. I offer some typical institution-relevant guidelines, and then give my two cents. Your thoughts are greatly appreciated.

Good guidelines for protecting institutions that I've come across:

Be factually correct- don't overstate your knowledge. 

Be transparent- disclose your connection to and your role with the institution your institution.

Control your institution email address- only use you .edu address for official business.

Control your privacy settings.

Weak guidelines:

Adhere to the institution pledge/code- pledges and codes offer few specifics.

Obtain permission- what warrants permission? Every single tweet? Blog posts that mention the institution? 

My Two Cents:
One of the first things newly minted medical students do is sew their school’s seal on their white coat, offering a continual reminder that they represent their medical institution whenever they wear this coat. However, they do not have any badge to remind them of this when they are online.

Medical school has particular demands and stresses beyond those of many other educational settings. In my experience, stress and unhappiness were commonly transferred to professors, courses, and the institution as a whole, often with discomfiting vehemence. It was not uncommon to see these expressions find their way to facebook.

More than simply protecting themselves, medical schools owe it to their students to prepare them to represent the institutions to which they will belong in the future. As future doctors, medical students will find themselves building and maintaining professional relationships for decades, each with different cultures and expectations of openness, sharing, and representation. The earlier these skills are developed, the better off students will be.

Many of the obligations and features of operating in the social media space derive from issues of professionalism. Social media training is an opportunity to teach professionalism, not only in content but also in practice. In my experience, features of professionalism have been taught didactically, and participation has consisted only of personal reflection. Social media training, specifically regarding representing an institution, offers a means to actively engage students with these crucial issues.

How do we protect institutions from students’ damaging comments, made deliberately or spur-of-the-moment? Again, the middle way between abstinence and indifference lies in student training about creating content that appropriately represents those to whom institutional membership impinges upon. A first step is to characterize for students the nature and extent of their obligations to the institution. The specific stakeholders who depend on the institution’s “good name” should be detailed, along with their depth of connection. A potential method is to start with the individual student and work outward. When you speak about your school, you are indirectly speaking for yourself, your classmates, all students, and all alumni who have dedicated years of study and will have/do have certification/validation of their life’s calling in the form of diplomas. You speak for the faculty and staff who have staked their livelihood on service to the institution. You speak for the administration who have staked their professional reputations. You speak for the clinicians you aspire to be. You speak for the patients who have chosen to be treated here. You speak for the community members who respect your institution as an integral community fixture.