The Future Of Medicine Is A Problem and An Opportunity For Young Doctors

Creating Opportunity In Your Future Medical Career.

The world of medicine that the next generation of physicians will be inheriting from their predecessors is the most advanced, complex and dysfunctional in the history of humankind. As future physician begin to take the wheel of a health care system that is at times revolutionary and at times in complete disarray, we must realize a few important facts.

• We will become the leaders of a heath care system that will have new pressures and demands placed on doctors at an unprecedented rate.

• We will enter a world with a global aging patient population. This is happening at a rate unseen by any previous generation of physicians and this rate will only continue to increase.\

• We are entering a more centralized medical care system. This centralization will take place at both the patient-physician and physician-hospital level.

• The economics of modern medicine demand increased specialization among doctors and this will continue to progress as biomedical advances progress. 

These simple facts about our modern health care system present a laundry list of problems and opportunities for young doctors. It also places us in a position to suffer or thrive more than any group of doctors in medical history.

This means one thing, the traditional approach will not work....

The level of specialization, rapidly changing knowledge, outside pressures in today's medical practice has evolved beyond the current medical education models which are still largely build on the 100 year old Flexner Report. Thus, the length of study, focus, and framework are build around principles of medical education have not kept up with the pace of modern medical practice. In fact, there are some leaders in medical education that are and have been calling for a complete overhaul of the US medical education system.

In an interview for the University of Virginia Magazine Dr.Randolph Canterbury, the medical school’s senior associate dean for education said this,

It’s become pretty clear in the last couple of decades that this is probably not the best way to learn something as complex as medicine. The idea that physicians ought to learn the facts of all these various disciplines—anatomy, physiology, biochemistry and so forth—to the depth that we once thought they should doesn’t make much sense. About half of all medical knowledge becomes obsolete every five years. Every 15 years, the world’s body of scientific literature doubles. The pace of change has only accelerated. The half-life of what I learned in medical school was much longer than what it is today.

There will need to be huge changes to every level of the medical system and medical school is not exception. I feel that student doctors who realize medical school cannot, and will not teach them everything they need to make in the future are best in the position for success.

Working hard to learn the skills taught in medical school is imporant but when you consider that most of what you learn will be outdated in 5-10 years, it makes you look at your grades differently.

Yes, getting good board scores and having a nice class rank are important, but the will not be important past residency.

Doctors will no longer expect to graduate and have a killer practice handed to them on a platter. Skills like networking, leadership, managment, and creativity are all vital if you want to separate yourself from the crowd once you become a doctor and they are all completely impossible to teach in a lecture hall.

Innovating In Health Care As A Young Physican

Looking to change healthcare with your new idea but don't know where or how to start?

Look no further...

Arlen D. Meyers MD MBA, is the cofounder, and Chief Medical Officer of MedVoy, a medical tourism company. His is also a Professor of Otolaryngology, Dentistry and Engineering at the University of Colorado at Denver. He has authored of a new book called The Life Science Innovation Roadmap: Bioscience Innovation Assessment, Planning, Strategy, Execution, and Implementation and currently serves as CEO and President of the Society of Physician Entrepreneurs at www.sopenet.org

I asked if he could give a quick overview of the change in healthcare that is happening right now and some areas where these changes are creating opportunities for young physician entrepreneurs to make a big impact.

Enter Dr. Meyers

None of us needs to be told that the US healthcare system is undergoing change. Designed for yesteryear and showing signs of dysfunction and age, our system is cracking under the strain of an aging population, escalating costs and poor technological progress.

Things have changed in several important ways:

• Health Insurance Reform and changes to the Reimbursement model
• Decentralized patient–centered care
• Downsizing /right-sizing the healthcare workforce
• Electronic medical records, healthcare information exchanges and data analytics/BI
• Acute to preventive care
• Disconnected to integrated care
• Medical travel: The search for value-based care
• Mobile health
• The emergence of non-US markets for biomedical innovation
• Increasing regulatory scrutiny
• The changing intellectual property landscape
• New healthcare delivery models: telemedicine, concierge medicine, hospitalists
• Physician-industry conflict of interest and transparency requirements

These market shifts can be lumped into four categories, each an opportunity for you to make a difference.

The first is healthcare information technology. The infrastructure emerging has four basic components: electronic medical records, health information exchanges, data analytics and business intelligence and telehealth/telemedicine. They all serve as elements of a rapidly evolving national healthcare information architecture that will be second nature to you and your patients someday. Using the system will be as easy as putting your card in an ATM machine in Nairobi and getting US dollars.

The second category are those changes and models designed to deliver care more efficiently and effectively than the present face-to-face model, where the patient has to come into an office or hosptial to see the doctor for minor check ups or follow up visits. Examples include on-site clinics located in businesses, disease management facilities, intermediate care clinics and pharmacy based offices.

The third group attempts to make billing and collection better, faster and cheaper. Processes like identity verification and authorization, real time benefits verification, dependent validation and benefits comparisons are designed to make sure the right person is getting paid the right amount for the right reasons.

Finally, the ground is shifting under the biomedical innovation infrastructure. Changes in regulatory rules concerning manufacturing, marketing, FDA approval, and intellectual property are but a few of the manifestations. There are huge opportunities to create positive change for the way doctors treat disease.

If entrepreneurship and innovation sound interesting to you, start learning about it now. (in medical school, residency, or even college as a premed) This is not something you will get during your medical training and there are lots of resources to help young physicians learn the world of bio innovation.

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A big thanks to Dr. Meyers, and if you want to learn more...

Join the Society of Physician Entrepreneurs, it's free and there are a ton of great resources to help doctors learn to be entrepreneur. Check out SoPE Here

Check out Dr. Meyer's new book The Life Science Innovation Roadmap: Bioscience Innovation Assessment, Planning, Strategy, Execution, and Implementation.

Do What You Love Guide: Tips On Keeping Dreams Alive During Medical Training

"Reality is merely an illusion, albeit a very persistent one."- Albert Einstein

From the outside looking in, becoming a medical student is not unlike scoring one of Willie Wanka's golden tickets. Most people see you as someone who is on the fast track to living a life of your dreams. They hear you are going to be a doctor and already picture you healthy and happy, with a condo at the beach. Sadly, the burnout rates and frustration amount physicians are on the rise, especially in primary care, and this trend does not seem to be changing any time soon.

Medicine is a culture with very rigid structure. Each type of physician is supposed to fit into a predetermined personality, way of practice, and even work schedule. There is a certain amount of brainwashing that is built into the system and it can be difficult to dream big and chart your own path in this sort of environment.

We are well into the graduation season and this means there will soon be many med students embarking on a new journey as residents, and many college grads preparing to hit the books as medical students. I thought this would be a good time for some tips on Doing What You Love.  For that we turn to someone who has helped many people follow there dreams...

Enter Leo Babauta, the founder of ZenHabits.

I wrote the first words of ZenHabits more than five years ago, I had no idea those few keystrokes would change my life.

I thought I was doing nothing more than reflecting on the changes that had been happening in my life, sharing a bit about what I learned with a handful of friends. I thought those tinkling of computer keys would fade into the void, as most of my thoughts had before that.

I never imagined that a year later, I would have 26,000 people reading my blog (and eventually a quarter million subscribers), that I’d finally be out of debt, that I’d have my first book publishing contract, that I’d happily hand in my resignation for my day job. All of that was out of the realm of possibility.

That’s the amazing realization here: that we rule out the possibility of great change, because it doesn’t seem realistic. For nearly two decades I focused on going to college, and working at a day job that I sometimes enjoyed but often dreaded, because that’s what we expect should happen. Starting my own business, pursuing my dreams, doing something I loved? Crazy talk.

Crazy talk is what I’m going to give you today, in hopes that perhaps one of you will expand your possibilities. It is possible — I did it, all while working a full-time job, doing free-lance writing on the side, and having a wife and six kids. I did it, even if I never dared to dream it for the first three decades of my life.

I am not someone who likes to give career advice, or teach people to be entrepreneurs. So I’m not going to do that here. I’ll just tell you this: it’s possible. And I’ll share what I’ve learned, in small snippets of goodness, about doing what you love.

If you don’t think it’s possible, do a small easy test.

Don’t think you can start a big/impossible idea? Start small. Take one small step in the direction of your dream. You don’t even need to tell anyone about it. It costs nothing, risks nothing, takes almost no time. But you will learn you can do that one little thing, and if you pass that test, you now know your theory of impossibility was wrong.

Expand your tests.

If you pass the first test, do another small one. Then another. Keep going and notice your confidence grow. Your skills grow along with the confidence. It’s amazingly simple. Iterate and re-iterate as long as you are having fun.

If you don’t know exactly what you love, don’t worry.

There’s no need to figure that out right away. Try something that someone else is doing, and see if you think it’s fun. The real fun part, btw, comes when you start to get good at it, so perhaps stick with it for awhile and enjoy the learning, then enjoy being good at it. If that first try doesn’t work, try something else. You don’t have to commit to one thing for your entire life. You can do a dozen a year if you want, for a decade. You’ll probably find something by then.

Find inspiration.

Think about what will inspire you 10 years from now. Who else is doing what you love doing? Who is excited about it most? Follow them. Learn about them. See what path they took. Watch closely how they execute, what they do right. Learn from the best.

Reach out to a mentor.

Of the people who inspire you the most, try to make contact with a few of them. If they never respond, try a few more. See if you can buy them lunch or coffee. Don’t pitch them on anything. Just ask for their help, and say you’d love for them to mentor you in a way that won’t take up much of their time. Don’t demand a lot of time, but go to them when you’re having trouble making big decisions.

Choose one passion at random.

Some people have many interests and don’t know where to start. Pick one or two randomly if they’re all about equal, and just get started. Don’t let choice paralyze you. Get started, because in the end it won’t matter if you started with the wrong passion — you’ll learn something valuable no matter what. Read more.

Get good at it.

You get good at something with practice. Allow your friends and family to be your first audience, readers, customers. Then take on a few others at a low cost, or increase your audience slowly. But always have an audience or customers if possible — you’ll get good much faster this way, with feedback and accountability. Read about it. Watch videos. Take a class. Join a group of others learning. Find people to partner with. Before long, you’ll be good at it.

Help others.

One of the best ways to get good at something is to help others learn. Making someone’s life better with your new skill is also an amazing way to get satisfaction out of what you do, to love what you do. Help as many people as you can in any way possible — it will pay off.

Find your voice.

Eventually, as you master your skill, you will learn that you are different than the thousands of others doing it. You will find your uniqueness. It’s not necessarily there at first, because you might not have the technical skills to express yourself. But eventually, find that voice. Find the thing that sets you apart, that helps you to stand out from the crowd. Then emphasize that. Read more.

It’s the doing and loving that matters.

Many people focus on growing, or hitting goals, or making money, but they forget what matters. What matters most is loving what you do. If you love it, and you’re doing it, you’ve already succeeded. Don’t worry so much about achieving certain levels of success — people push themselves so hard to reach those things that they forget to enjoy what they’re doing, and in the process they lose the reason they’re doing it in the first place.

Dream bigger.

Once you’ve overcome the initial fear and started to become good at something you love, dream bigger. The first stage is small steps, but don’t stop there. You can change lives. You can change the world. Doing so will change you.

Fixing Patients In A Broken Healthcare System

"Status Quo, you know that is Latin for "the mess we're in."" -Ronald Reagan

As I glanced at the chart of my next patient I felt my heart sink. It was littered with warning phrases; words like progressing, recurrence, and worst of all, suspicious. Most of the time these charts are filled with unintelligible scribble recorded in a half-hearted SOAP format. A few lab results, a differential diagnosis or two, followed by the solution to the patient's ailment. However, as a medical student, you learn to develop an eye for the warning phrases. Once they begin to pop up you know that a doctor is trying to communicate that this patient’s findings are giving them a bad feeling. It seems that once you have been in the game for some time you develop a visceral reaction when you see certain patients. It transcends the lab tests, the imaging studies, even the all hallowed physical exam. There is some thy of "gut factor" experienced physicians develop, and evidently my patient had triggered a few on her way to see me.

“Do you people even care if I live or die!?” My patient blurted out as I entered the room, she looked tired, exasperated, and scared. Her question left me reeling, but only for a split second. I knew that this was one of those questions that required a swift and definite answer. You have a similar time frame when your wife or girlfriend inquires about her outfit and if it makes her look fat. Of course in that case the only response is an immediate and decisive “are you kidding, no....” Thought the implications of this encounter where much more serious. I did my best to deliver an answer dripping with as much empathy and reassurance as I could heap on, but I knew in my heart that I could not deliver the full truth to my patient.

Of course it’s ludicrous to think that any doctor would ever have total indifference toward the lives of their patients, however, we are the face of a system that, by some measure, truly does not care. This patient had recently lost her job and the “perks” of health insurance that came with it. I knew that eventually she would be able to get the care she needed but I could not have confidence in the timeliness of this remedy. This is understandably disconcerting for someone with a mass relentlessly growing (and possibley spreading) inside your body, with no regard for the timing of an overloaded clinic schedule.

The simple reality is that we work in a world of limited resources and at some point there must be people who will bear the brunt of this limitation. As it stands now the nature of selection favors those who have the means to pay for options. In some ways, this may always be the case but I do feel that we can do alot to make the system better. The political rhetoric surrounding health care at the moment is in many ways missing the boat because no matter how many people you give access to health care we still come back to this issue of limited resources. Sure you can give everyone health insurance but it won’t mean anything if it takes 5 years for an appointment to get your colonoscopy done so the doctors can rule out colon cancer. All you have done is substituted one form of selection for another.

I do not know what will become of my patient. I want to truly believe she will get all the appointments in all the free clinics that she needs in a timely manner so that she can go on and live a meaningful life. Though by the end of our visit, after calling various clinics, and coordinating lab tests that must be complete before surgery,  I have begun to develop an imperceptible feeling in the pit of my stomach. I cannot seem to shake it off as I go back into the exam room. I try my best to hide it and leave my patient with a bit of hope as we part ways.

As I go forward in my medical training I not only see the challenges of developing my own clinical skills as a doctor but I also see that future physicians will be taking over a health care system that is, at best, overburdened and, at worst, dysfunctional to the point of breaking. It is for this reason that our health care system is in need of a different type of doctor or at least a greater variety of them. Attributes like creativity, vision, outside-the-box thinking, and risk taking are likely not the ones that got you a spot in medical school or residency. However those character traits are the ones that must be cultivated in the next generation of physicians as we move forward in finding better ways to care for our patients.

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.