5 Must Watch TED Talks For Any Medical Visionary

Visionary people face the same problems everyone else faces; but rather than get paralyzed by their problems, visionaries immediately commit themselves to finding a solution.    -Bill Hybels

Ok, I'm sure you are all familar with TED.com, basically it's is like crack for those who thrive on big ideas. I must admit, TED is a bit of an addiction for me. So if you have a bit of extra time this weekend; here is my must watch list for anyone who wants to do big things with their medical career.

1. The Wireless Future of Medicine

Eric Topol says we'll soon use our smartphones to monitor our vital signs and chronic conditions. At TEDMED, he highlights several of the most important wireless devices in medicine's future -- all helping to keep more of us out of hospital beds.

Eric Topol is a leading cardiologist who has embraced the study of genomics and the latest advances in technology to treat chronic disease.

2. Medicine's future? There's An App for That

Daniel Kraft offers a fast-paced look at the next few years of innovations in medicine, powered by new tools, tests and apps that bring diagnostic information right to the patient's bedside.

Daniel Kraft is a physician-scientist, inventor and innovator. He chairs the FutureMed program at Singularity University, exploring the impact and potential of rapidly developing technologies as applied to health and medicine.

3. Robert Fischell on Medical Inventing

Accepting his 2005 TED Prize, inventor Robert Fischell makes three wishes: redesigning a portable device that treats migraines, finding new cures for clinical depression and reforming the medical malpractice system.

Robert Fischell invented the rechargeable pacemaker, the implantable insulin pump, and devices that warn of epileptic seizures and heart attacks. Yet it's not just his inventive genius that makes him fascinating, but his determination to make the world a better place.

4. How Do We Heal Medicine?

Our medical systems are broken. Doctors are capable of extraordinary (and expensive) treatments, but they are losing their core focus: actually treating people. Doctor and writer Atul Gawande suggests we take a step back and look at new ways to do medicine -- with fewer cowboys and more pit crews.

Surgeon by day and public health journalist by night, Atul Gawande explores how doctors can dramatically improve their practice using something as simple as a checklist.

5. Where Good Ideas Come From

People often credit their ideas to individual "Eureka!" moments. But Steven Johnson shows how history tells a different story. His fascinating tour takes us from the "liquid networks" of London's coffee houses to Charles Darwin's long, slow hunch to today's high-velocity web.

Steven Berlin Johnson is the best-selling author of six books on the intersection of science, technology and personal experience. His forthcoming book examines "Where Good Ideas Come From."

Harvard & MIT Launch edX Worldwide Education Platform

Harvard & MIT are launching edX, free education online for anyone in the world.

Watch the launch video below. Go to edX

edX joins Coursera.org, a similar venture involving Stanford, University of Pennsylvania, University of Michigan and Princeton University.

The goal according to edX is to educate a billion people online.

The 5 Top Inventions That Will Make Being A Medical Student Or Resident A Breeze

The Future Of Medical School and Residency

1.Never Miss Another Pimp Question With Google's Project Glass

Google is working on a pair of glasses complete with a heads up display inside the lens. Soon you'll have an Android Operating System right in front of your eyes. If the attending asks you for 15 differentials for a patient with dizziness you can give her 20. Also sweating through another operating room anatomy pimp session will be a thing of the past. Just pull up the Netters app on your glasses and tell the surgeon to bring it! The glasses are slated to hit the market by the end 2012 at a cost of between $250 and $600. So start saving your student loan money now.

2. Never Forget the Definition of Any Medical Term With Touch-Hear

This idea is from National University of Singapore's Design Incubation Centre. Essentially, by touching a word or phrase in a particular piece of reading material, the user can listen to its related information such as pronunciation and/or meaning. Those obscure medical terms that are always on the tip of your tongue but you just can't remember will not be a problem. If a question says, the patient has astasia-abasia, asomatognsia, abulia, and anosognosia and you are lost? No problem, you now have the answer at the tip of your finger.

  

3. Holding Retractors in a 20 Hour Surgery? No Problem With a Powered ExoSkeleton

Currently being developed by the United States Army for application in combat. The powered exoskeleton gives a person super human strength. Current models increase your strength 10 fold and will never fatigue. Imagine how much easier holding that butt cheek retractor will be once you can slip on an exoskelton.

4. Long Lectures Become Fun With Flexible/Foldable TV Screens

Soon those gruelling all day medical school lectures will turn into a wonderful experience. Just bring a stack of notes or text book and slide your TV screen into the pages. Instead of keeping up with the professor's boring lecture you could be Keeping Up with the Kardashians. Just remember to move your highlighter around from time to time so they don't suspect something is up.

5. Take the 80 Hour Work Rule And Laugh In It's Face With Turbo Snort

The product is called Turbo Snort, I really don't think much more needs to be said. One bottle boasts 400 hours of energy. With Turbo Snort you will be able to huff your way to success in medical school and beyond. Just slip on a pair of google glasses, an exoskelton, and take a shot of Turbo Snort and you will become the Medical School Gunner version of Iron Man.

The Passion Manifesto: Why Every Medical Student Should Rethink "Traditional" Medicine. (Part 1)

A personal yet rational case for the pursuit of the moon, and stars... and throw the asteroids in while we're at it. Heck, wrap it all up for a "to go" order. 

I can’t push these questions out of my mind.

They seem to invade my skull with a fervor that can only be explained by the fact that the answers will determine what my future life will hold.

Will it be a life defined by passionless work, constantly feeling out of kilter in an environment that just wasn’t quite made for me? Will it be the romantic visions I indulge in of a man on a mission in the heart of a wild land, with an invaluable skill and zeal to match, righting the wrongs in a forgotten corner of the world? Will it be relegation to a large grey building filled with sick and dying people who in many cases won’t lift a finger to help themselves, but frustratingly expect to be cured by modern wizardry and a pill? Will it be the life of a nomad, drifting from here to there; in and out of towns and countless lives, cursed with an incurable nomadic soul? Perhaps the life of a key-clicking storyteller will be mine. Writing the stories that deserve to be told of the unsung hero, the underground hero that deserves recognition and a face.

These are the questions that have been floating through my cerebral cortex of late. They will not go away, they will not improve, I cannot banish them from my thoughts.

Some people seem at ease living a life unexamined. I cannot indulge thusly. I need my existence to mean something. I need my action to be meaningful and deliberate. I need the possibilities to be endless. I need to believe that I can be passionate about how I am living NOW and not just scraping for a grade, which will POSSIBLY eventually lead to a small measure of meaning. I need to be on top of my game and in the moment and full of the rapturous joy of living. Pain? I can handle it if an end is in sight. Disappointment, I can weather it if I am convicted of my cause. Grief, I can bear it if I see the purpose in it. What I cannot abide is an endless number of days filled with a transient existence… mere platitudes in exchange for a real life of weight and substance.

Money is fun, yes, but past what is needed to maintain some semblance of comfort it matters little me. I hold this view principally because I have little of it, if I possessed a fortune my tune would doubtless change. That very fact is a good reason to steer clear of fortunes. Money. That pitiless taskmaster under whose whip so many voluntarily bows their heads. That alter upon which so many sacrifice their souls and lives.

Embrace the gambler?

Some would call me a gambler. Willing to risk the safety and certainty of a “stable” and “responsible” choice in lieu of the moon. “The paradigm you seek is unattainable,” they say. “The reality you pursue is not measurable or concrete in a way that we agree with, and it makes us uncomfortable,” more accurately reflects the sentiment.

I am not lauding the senseless disposal of resources into that most heinous of bandits in need of a prosthesis, but at the gamblers heart is not evil. That misguided soul has hope, albeit of a gnarled and mangled fashion. They would turn nothing into something, if they had their wishes. All the gambler’s underpinnings are not sordid and ominous. They possess the ability to lay things of importance down, to detach themselves from the sure thing in pursuit of the dangling possibility. A gambler is really an entrepreneur, gone wrong.

To harness that talent means to be a successful investor, to over-indulge and misalign that same gift means to fall into that certain and stealthy abyss. Addiction or passion? The wafer thin wall that separates the two is often nearly translucent. That may be why so many won’t allow themselves near it, for fear of breaking through.

Passion is a strangely amorphous, yet universally desired, commodity. It as been directed at nearly every conceivable endeavor from the seemingly mundane act of button collecting to such adrenaline-drenched pursuits as hurling one’s body from a ledge wearing naught but a glorified sheet stuffed haphazardly into a backpack. The domicile of this enigmatic feeling is often hard to predict. It can spring up and take root in nearly any soil; no matter how seemingly desolate or blank the slate appears. Passion is also desired by nearly all humans, but in spite of all these favorable characteristics, this most sacred of grails is a painfully scarce commodity.

I am going to hazard a wager. My wager is this: that nearly every singular activity at which a passion has been directed throughout the whole of history could/ has/ or will be molded into a monetarily feasible proposition. Creativity and ingenuity will be required, more in some cases than others, but the POSSIBILITY is there to turn nearly every activity or passion into a business model.

Now I will take that last paragraph, blind fold it, and turn it loose in a different direction. Can a person find something they are passionate about doing, an activity that drives them to pursue perfection unharried, in virtually any existent professional circle? It is an interesting question to be sure.

Is passion even possible in medicine?

Sadly, medicine has one of the greatest potentials of any professional to be a soul sucking passion-sink. I have been a first hand observer of this throughout my life. My family is somewhat of a medical mafia family. The strange customs and rituals, the secretive and enigmatic lingo, the bleeding together of home and work, the all consuming nature of the "family business," and even the fact that a lot of blood flows in the course of doing business... all similarities between my medical family and the mob. 

I HAVE seen many family members use the profession as a means to do great good, while preserving and USING their external passions to do so and I laud them for this ability. I have also seen people in my family loose themselves, their spark, their drive and passion, because they pursued medicine instead rolling the dice on a dream. 

If one is going to "do medicine," without losing their soul... it is going to be a no-holds-barred royal rumble. It is not a profession that generally rewards the balanced individual. The individual that seeks a medical career, but also desires a sane lifestyle. People that work a normal amount of hours or try to work more efficiently are often viewed as being a slacker (I am experiencing this first hand as I try to keep balanced during first year).

In the established medical system, the gambler is wholly vilinized. Keep your head down and follow the protocal. Don't make waves. Don't suggest a good idea to an attending or you'll be singled out for a good old fashioned pimping. Work harder. Whether you are working smarter or not is of lesser importance. Give up your hobbies. Be consumed by the profession. Cover your ass in lieu of making the objectively correct decision.

These are generalizations sure, but too often accurate ones. The really sad thing is that many times the aforementioned traits are touted as preferable or morally superior in some skewed sense.  It isn't explicilty verbalized this way, but the predominent currents flow from these icy tenents. Going down this rabbit hole is supposed to somehow makes you a better doctor. 

This is NOT the case.

The new generation of doctors are beginning to realize this. As compensation decreases and information load increases, young would-be doctors are forced to take a hard look at medicine for it's face value. The days when benjamins could universally override doubt are slowly coming to a close. This article has some salient points and perspective on why this is the case. Suffice it to say that the ROI is often not good enough anymore to make people part with their less secure dreams and a "balanced life."

The status quo is being challenged. The "medical establishment" is realizing that it is having a harder time recruiting the top tier of innovators and free thinkers that will push medicine forward. 

Passion and innovation must be rewarded or this will continue to happen. The gambler must be embraced and utilized. Balance must be encouraged. A more human person will also be a more humane person.

Can a medical student (as I find myself) find passion in medical school by starting a medical school blog, even if they currently find their situation passionless? Can a previously stolid accountant breathe passion into his professional world by changing a venue, entering a niche, or altering a mental paradigm? Can a barista gain a passion for their work by starting their own mobile coffee cart instead of working at a major coffee chain that shall remain nameless (it rhymes with car-ducks). I posit that in many or most cases this is possible.

Not ALWAYS possible though... If medicine is not your passion GET OUT MAN! Make a responsible exit strategy and EXIT. If you can be passionate in a different part of medicine, CHANGE your course. Get into something that you think is FULLY great.

The tortuous road to the moon.

When a person sees that it is not a feasible proposition to turn their current pursuit into a passion... why then do they persist? There is no excuse for this! There are more niche market opportunities now than there has ever been in the history of the earth! That statement should be self evident in describing the possibilities. Allow me to provide examples.

There is a guy who’s living, his calling, his passion is to read the mail of complete strangers and expose their secrets to the world… His name is Frank Warren and he is the founder of Postsecret.com

There is a man named Jerry Greenfield who thought he wanted to be a doctor. He, in fact, applied on three separate occasions to medical school and was denied each time. He thought he wanted to be a doctor, but it didn’t seem to be working for him. He decided to take stock of his passions. He loved ice cream. He wanted to start a small business. He took a $5 correspondence course on ice cream making and promptly opened a small ice cream shop in Burlington Vermont with his long time friend Ben Cohen. You may have heard of his shop. It’s grown a little since then. It’s called Ben and Jerry’s.

There is an individual who was in medical school at Harvard University. During his time there, he found that he was spending much of his time writing instead of studying as religiously as many of his classmates. Realizing that art of the pen was his passion, he decided not to discard it and continued writing feverishly throughout his four years of medical school. When he graduated, instead of stuffing his aspirations on the back shelf and entering a full time clinical career, he began the risky proposition of writing full time. It turned out to be a good move for him, because in 1994 he became the only creative artist ever to have works charting at #1 in film, TV, and book sales simultaneously. If you have ever seen the film Jurassic Park, watched the television series ER, or read one of his numerous best-selling books, you have appreciated Michael Crichton’s decision to follow his passion.

Engaging in passionless work is one of the greatest crimes that can be committed against oneself and society as a collective entity. Creating a passionate place where one can use their natural gifts for betterment of humanity and fulfillment of self, conversely, is one of the greatest goods.

These thoughts continue to consume my mind. They will leave me no peace until I have donned the unitard of action and wrestled with my doubts. Will it require a roll of the dice or a calculated reshuffling of the cards I have been dealt? Likely Both. The platitudes must stop. My life can have passionate direction. It will. It must. This is my manifesto.

Through the slightly course language, this guy makes a great point. 

Dr. Toby Bond & The Future Of Private Primary Care

Using the EMR to Minimize Stress in the Office

This past month I have had the pleasure of rotating with a visionary internist who is leading the way into the new era of American primary care. In a time when many independent physicians are closing down, Dr. Bond is just getting started, opening his doors in the college town of Athens, Georgia in 2010. If you're a student interested in someday going out on your own, you should find his business model encouraging and his managemet tips helpful.

Dr. Bond, while considering himself an "old fashioned family practice", has done a number of things very differently. "We've embraced the technology," says Dr. Bond. "By opening our doors in 2010, I was aware of the future of the electronic medical record. We invested heavily in a system that would work for us, and designed the office to be paperless from the ground up." By accomplishing a modern office, he is now years ahead of offices who are laboring to transfer established paper charts to their EMR. And trust me, this makes a world of difference in job satisfaction. "I'm done with the note when I leave the room. There's no stack of charts at the end of a long day."

When discussing why his office runs so smoothly, Dr. Bond gives credit to his staff. "Hire a strong office staff, train them well and compensate them accordingly." The office staff is indeed very impressive. They are well-trained to work as a unit. Each member of the team plays a vital role in the workflow of building the initial electronic chart, scanning records, scheduling specialist visits, drawing labs and recording phone notes. And at the end of the day, it is all available at the click of a button.

In marketing his practice, he targets those patients who will appreciate the technology. "We have an online patient portal, so we market to those who might appreciate the access." By using targeted advertising such as the nearby University of Georgia athletic events, his practice is well attended by young university-associated patients.

The electronic record is more than a note--it has major implications in billing, which is tracked by Dr. Bond directly. "Previously practices would be months behind in billing, often resulting in a large number of write-offs on labs and procedures." By combining the practice's electronic system with some knowledge of how notes are related to billing criteria, Dr. Bond is able to stay organized and on top of the current records. The use of computers to simplify the complex billing process will be what allows future independent physicians to keep their doors open.

The final product of a clever business model? A smooth work day, healthy patients, organized records and a much happier physician. "Medicine is a hard job no matter what specialty you're in," says Dr. Bond, "but it is much more enjoyable when you have time to spend practicing medicine rather than worrying about documentation." Seems to me that the small-town doc isn't going anywhere after all.

For more information you can visit Dr. Bond's website at www.drtobybond.com

Radiologists Putting Surgeons Out Of Business?

Looks like the scalpel might be getting replaced by a keyboard and mouse

I recently watched a video where patients underwent surgery without a single cut. It's pretty unbelievable! For the past 13 years, Yoav Medan has been working as a pioneer in MR guided Focused Ultrasound Surgery. As I watched this clip,  I had visions of my future self telling my grandchildren (in a crotchety old man voice) about the good ol' days when we used to get to cut our patients open and slosh through their insides during surgery....those where the days.  I guess surgeons will have to start being a little nicer to the radiologists. They may need a job from them someday.

Stop Asking For Permission

Here's to the crazy ones.

By Franz Wiesbauer MD MPH

When we talk to our physician readers at conferences or during coaching sessions, several themes keep coming up again and again: Doctors think they don’t have enough time, enough money or both.

When we coach them, we usually ask them “What could be a way out?”. Very often the response is – silence. Physicians are very often unispired when it comes to creative solutions to their own job frustrations.

Why is this so? We think that it’s the physician-mindset which is the problem. We, as physicians, have a permission-based approach to work. All our lives, we had to get permission for doing stuff: we had to get permission to attend a good high-school, a good college, a good medical school etc. After graduating from medical school, we had the permission to practice medicine as a resident, after the board exam we got another permission, then we go into a sub-specialty and we get yet another……you probably guess it: permission.

So whenever we ask our readers, friends and clients: “…you have passion xyz, why don’t you just try to make it a side-busienss?”, we usually hear: “because I was not trained to do that.” Which basically means: “nobody gave me permission.” Do you think Steve Jobs would have come up with the Apple empire if he had a physician-mindset? Do you think that Mahatma Gandhi was trained to be the leader of a peaceful revolution? Do you think that Richard Branson got permission from anyone to start his multimillion empire? The answer is of course – “No”. And why “No”? Because most of them were the first ones to do the shitake they were doing. There just was no one around to teach that stuff.

So what do these successful people have in common?

1. They had an idea
2. The courage to start
3. The self-discipline to follow-through
4. The abilities of an autodidact

You passed all those difficult hurdles, you went through medical school and you probably are used to busy and exhausting work of a healthcare setting. So it is very likely that you have the stamina to follow through. We also assume, you are a quick and autonomous learner. Moreover, as we know from our talks with many of you, you might even have an idea. It is cristal clear, what’s holding most of you back from just f*n doing it is: FEAR. You don’t yet have the courage to start. And we will change that.

About: Franz Wiesbauer MD MPH is associate professor and clinical specialist for internal medicine at the Universiy of Vienna. His passion for healthcare and technology led him to found a physician e-learning company (123sonography.com) and to co-found MedCrunch.net together with Lukas Zinnagl MD. He is an author at Freelance MD.

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