Change Reality, in Your First Year of Medical School, with Kevin Maloy, MD & #MakerDocs

2017.05.17 Hacking Healthcare Georgetown University School of Medicine Washington DC USA 5040
2017.05.17 Hacking Healthcare Georgetown University School of Medicine Washington DC USA 5040 (View on Flickr.com)

When I was a first year medical student, no one offered to help me create software (I did it anyway, really simple stuff). In 2017, at Georgetown University School of Medicine, first year medical students go through the software creation lifecycle in a selective “Hacking Healthcare.”

FROM IDEA TO PROTOTYPE & PITCH IN 7 SESSIONS Hacking Healthcare DC

It’s taught by Kevin Maloy, MD (@MaloyKr), aka MakerDoc aka Change Reality, Talk about Magic, Learn Javascript. MakerDocs DC from this blog in 2014.

Kevin asked me to come give feedback to this year’s class, and per my policy, if I can walk to it, I’ll do it 🙂 .

This year, they had the expert guidance of John Lock, the ridiculously more-experienced-than-I-will-ever-be Entrepreneur-in-Residence at the famed Mi2 Medstar Institute for Innovation, and fellow feedback provider Dave Milzman, MD, FACEP, Associate Dean for Student Research and Informatics.

For me, it’s less about what the teams create (because by definition they are exceptional people and will create great things in their lives), and more about the way they create, and the heart and soul they integrate along the way. I could tell in 7 sessions that they learned how to

  • Tell a story about why something matters
  • Understand a real business need and how to prototype to it
  • Work through others to execute on a vision
  • Collaborate as a group

These are all great skills I know they, their patients, and their communities will appreciate later on. Some people work entire careers to master these.

I don’t know how stealthy the ideas are so I won’t reveal them. I was super impressed at the connection of the ideas to actual health, AND the design ethic that they brought to the work. I can see how a medical school would do well to create a learning experience like this, capture the spirit, and then check to make sure at every step of training that it grows and thrives.

It’s always a pleasure to meet a new generation of MakerDocs, and to meet them under the watchful eye of W. Proctor Harvey, MD, especially when you read what he stood for:

A strong advocate of the human touch in medicine, Dr. Harvey had a gentle bedside manner that extended to shaking hands with every patient and plumping up their hospital-room pillows. He believed modern physicians had become too dependent on technology and other diagnostic tools and had lost the ability to work with patients on a simple, person-to-person level.” – Washington Post, 2007

Just Read: Moral Self-Licensing – a continual challenge to eliminating bias in health care

Earlier in my career, I remember a colleague saying to me, in a challenge to observed, biased behavior, “this is organization x, those things don’t happen here.” He said it with a dismissive chuckle. And yet, it did happen…

I have been intensely interested in the concept of “Illusion of Objectivity” especially in health care, and so have done a deep literature review. It brought me to several helpful papers and the concept of moral self-license (Merritt AC, Effron DA, Monin B. Moral Self-Licensing: When Being Good Frees Us to Be Bad. Soc Personal Psychol Compass [Internet]. Blackwell Publishing Ltd; 2010 May [cited 2016 Aug 13];4(5):344–57).

One of the authors, Daniel Effron now at London Business School (@lbs), has written another piece more recently which I’ll post on next.

It’s yet-another-place where the professions outside of medicine can teach us a lot, and why shouldn’t they, we need each other, and our patients need us to perform our best for them.

Moral Self-License, a fascinating concept that shapes our actions

When under the threat that their next action might be (or appear to be) morally dubious, individuals can derive confidence from their past moral behavior, such that an impeccable track record increases their propensity to engage in otherwise suspect actions. Such moral self-licensing (Monin & Miller, 2001) occurs when past moral behavior makes people more likely to do poten- tially immoral things without worrying about feeling or appearing immoral.

Several study situations of note (summarized here, you can review for control situations, etc):

  • When people expressed support for a Black presidential candidate (Barack Obama), they were more likely to subsequently express bias toward less-qualified White candidates for a police job.
  • People asked to describe a time in their past when they acted immorally were more likely to endorse prosocial activities such as giving to charities.
  • The converse situation, people describing a moral act in the past were more likely to cheat on a math task

So there is something about doing (or even thinking) about past behavior that causes people to engage in less-than-virtuous behavior or to minimize the less-than-virtuousness of the behavior.

What does this mean for health care?

A lot.

There is much public controversy presently around institutions and people who express commitment to an unbiased environment, and yet biased environments persist.

Interestingly, further research shows that there is greater sensitivity to what is seen as hypocrisy by people in the affected, targeted groups, which makes sense. The converse, however, is that people who are not in the targeted groups are less likely to see hypocrisy and license biased behavior, which allows it to persist. This is a difficult problem if the actors and the licensors are all part of the same ingroup – there will be less introspection.

Here’s a reason why this is important

Explicit attitudes among medical students 54441
Explicit attitudes among medical students 54441 (View on Flickr.com)

Explicit and implicit attitudes among medical students 54443
Explicit and implicit attitudes among medical students 54443 (View on Flickr.com)

Because, today, medical students feel comfortable explicitly stating bias against lesbian and gay individuals (and even more bias against obese individuals), an atmosphere of moral license (“we don’t do that here, our policies say so”) can allow this to continue.

Note that because of the concept of impression management, students (and physicians, other research) are much less likely to openly state bias toward African American individuals, even though their behavior may reflect it (see: Just Read: Eliminating physician biases against gay and lesbian people, don’t forget the “T” ) .

Who I am vs What I do

There appears to be a protective effect in the understanding of a person’s commitment (who they are and what they stand for) versus what they do (progress toward a goal). Labeling is tied into this:

several studies have found that labeling people as ‘‘helpful’’ after they agree to a small request increases their likelihood of acting consistently by agreeing to a subsequent, large request

Value of Listening, Introspection

There are a few more papers that I’m going to summarize here, because this is such a fascinating topic, and frankly, a head scratcher for people in vulnerable groups who observe repeated, biased behavior in people who otherwise are committed to being bias free.

The reconciliation of all of this is that we are all human, and the “this doesn’t happen here” turns out to be one of the most dangerous statements that can ever be made.

As I reflect on some of the most impressive leaders and concepts I have seen/heard, they involve listening better (“Just Read: Just 6 more seconds of listening needed to elicit the patient’s agenda“) and understanding that improvement is always possible (“There’s Always Something to Do Better” – Medical College of Georgia, home of patient and family centered care). In the latter concept, just think about the statements from people who say they always want to get better and how compelling they (and the people behind them) are.

Working to be an Ally

Right now, I think one of the most topic areas for this exploration is the work of being an ally, to a group of people that is not your own. This is a space where the research points to a great risk of moral license (because the actor and the target are not in the same ingroup), and where, consistency is needed the most for the persons an ally is working to support.

Maybe good advice here is to be introspective about actions, query those who you are working to be an ally for about actions, and listen to their answer. Otherwise, a person may be inadvertently licensing themselves to do things they will not notice are unhelpful, and later regret. It’s what all humans do, therefore, work with other humans to mitigate this risk :).

This is still one of my favorite quotes (from: Not using the term “Transgendered” and respecting people) :

**Don’t get defensive**

If you get defensive, notice it and accept the discomfort of unlearning and relearning

This requires a desire to know, motivation to become informed, willingness to correct mistakes

Every Body Walk! and Make Roads Safe – hyper-Ignite at American Medical Student Association Annual Convention 2013

Help this Muppet

Below in timed version and self-advanced version, given at the 2013 American Medical Student Association Annual Convention (@AMSANational), in Washington, DC.

I decided to stray a bit from the Ignite format and instead do what I’m calling a hyper-ignite. 9.5 seconds per slide instead of 15. It’s 33% more efficient! Enjoy, and links to relevant web sites are below the script. Thank you, AMSA students, Make Roads Safe (@Make_Roads_Safe)

auto-advancing version

manual-advance version

 

The Script

 

  1. Hi. I’m Ted. I’m here on behalf of 17,000 physicians and 9 million members who are supporting the American Medical Student Association this year.
  2. I work in the super awesome Center for Total Health, just down the street, on Capitol Hill, which you are most welcome to visit 
  3. Here, we demonstrate what it’s like to train in and practice the best health care, 
  4. And talk about health, too – check out that 80 foot video touch wall.
  5. You’ve probably seen this sign and wondered what the heck it is all about, I’m going to tell you, starting with my story.
  6. When I was in medical school, hoping to become a family doctor, I was taught that the only way to listen to patients was in here – the medical office/hospital
  7. This is the image of being a doctor that I was taught, and the one that still exists in most of health care – only one way to be there for patients
  8. A few public health degrees later, I worked in Health IT, and now, we can listen and learn wherever our patients are
  9. After years of doing this, a discovery, based on listening to our patients when they weren’t in the medical office or hospital – where they live work learn pray and play. 
  10. Which is that health doesn’t happen here. 
  11. It happens here – notice the walking meeting
  12. It happens here
  13. It happens here. Those are solar panels – on the top of this medical office
  14. After learning about our patients outside of the health care system, I learned about the ways we can make sure all the work we do in our hospitals is not wasted – this is our carbon footprint. We’re the first US Health System to have a verified greenhouse gas emission inventory. And we’re to going to reduce it. By 30%, by 2020.
  15. But we’re all doctors, and I’m one, too, proudly a specialist in Family Medicine. So what should you do? We thought of that.
  16. That’s where walking comes in, and here are 3 things I’d like you to do.
  17. FIRST: WALK. Walk with your friends. Walk with your enemies. Walk using this app. When you have a difficult problem to solve with someone, walk with them. FIND the person in this room who you are least interested in spending time with and walk with them.
  18. Trust me, it works. And biology is on your side. When you move, you can manage yourself better, pay attention, and your brain actually grows new cells.
  19. SECOND: Partner with this doctor. Regina Benjamin, MD, MBA is the US Surgeon General. On April 1, she will start a process to create a new call to action around walking.
  20. She was with us 2 days ago telling us how important this is. Look for it, and participate, in the Federal Register, starting April 1, 2013. Why?
  21. It doesn’t matter if you become an endocrinologist or or an otolayngologist, walking helps EVERYTHING. It’s easy to recommend, and easy to do. There are a zillion benefits that will make your job as a doctor easier and more rewarding
  22. THIRD: Partner with this muppet to MAKE ROADS SAFE around the world
  23. Worldwide traffic fatalities will exceed diabetes and HIV in our generation. If we do nothing, 5 million fatalities, and 50 million serious injuries will result. Every 6 seconds, a person is killed or seriously injured on roads.
  24. May 6-12 is Global Road Safety Week. Take a long short walk, register it at mylongshortwalk.org and tweet using the hashtag #walksafe
  25. And by the way, it’s better for your health, too. Do it for that reason alone.
  26. We took a long short walk. We celebrated that we’re fortunate to be able to walk safely. 
  27. If you think this is an international problem, think again. even in the United States, a walk to school can end a child’s life.
  28. Be aware, be a leader, and you can save lives inside the health care system and outside of it, too.
  29. The last thing I want to say is Thank you, good luck, we support you, and we’ll see you next year, if not sooner!
  30. Thrive.

Links

Community Medicine – Total Health – Dialogue with and from the future at Penn State Hershey

I had the most delightful dialogue with the medical students of Penn State College of Medicine, Hershey’s American Medical Student Association campus chapter and Family Medicine Interest Group (@PSFMIG), on the topic of “Community Medicine.”

Ilene Tsui (@iktsui) and Carina Brown, first and second year medical students were my hosts. I had hoped to come to the famed city in person, then I realized it would have to be by video from Washington, DC, then I realized it would have to be by video from Denver, Colorado, but we did it.  It is very poor form to stand up medical students, so thanks to my executive-level colleagues for agreeing to catch up on some work in the lobby while we chatted. The commitment to the future is strong here.

Slides are below in two formats (slideshare and “easy access”). Ilene also sent me some questions before hand which I’d like to answer here. If anyone out there wants to answer them also, be our guest, more experience is better. Just post in the comments. Here goes.

1. How will medical education be changing over the next few years? Do you see residencies becoming more streamlined for those interested in specialties?

I’ll just insert my hope in here, which is that medical education will not prepare people to be excellent doctors, it will prepare people to be excellent leaders and citizens with the knowledge, skill, and behaviors of physicians to support individuals, families, communities, society, to achieve its/their goals through optimal health.

If we look at what the public expects from doctors now and in the future, it’s to be stewards of more than hospitals and medical offices. This is really good news, medicine is an incredibly versatile profession, there are many places and situations where we can heal.

I’m not sure what to say about the streamlined question. Might need more background on that one :).

2. Where do you see primary care practices in ten years? Do you think the concept of private practices will exist in ten years?

I think they will. The question is what will they be like. I had to go look up the data myself, because I’ve been in a group practice my entire career (and I’ve not looked back). According to this report, we’re set to be at 36 % independent physician practices by 2013, down from 57 % in 2000.

I’m clearly biased. I trained in a multispecialty group practice that supports collaboration for the health of everyone, saturated with technology, systems, and leadership training to make it all work.

Kaiser Permanente Rock Creek, Lafayette Colorado 19647

Kaiser Permanente Rock Creek Medical Offices. The future is here.

I think this is a good time for me to say, even though I wasn’t at the Center for Total Health in Washington, DC, when I was talking with you, my Penn State friends, I was still coming to you from the future. I was at Rock Creek Medical Offices, part of Kaiser Permanente Colorado (@KPColorado), and the day before at Skyline Medical Offices in Denver, where I was spending time with:

  • Dermatologists, who are using video technology to connect to their primary care peers (and their patients) to make sure they are excellent clinicians in their own practices, and make themselves available as clinicians as well. We were told the average time to see a dermatologist at Kaiser Permanente Colorado is now 3 days. Let’s repeat that: 3 days.
  • Neurologists, who are doing the same, using video technology also to connect, and in the foreground, synthesizing for every patient a substantial amount of thinking and knowledge across all their specialty colleagues for every single patient. A complicated neurology case can have 2, 3, 4 specialties consulting, and to have their work bundled together in one comprehensive electronic medical record is beyond priceless. And, it’s not just the bundling of their knowledge, it’s the bundling of their collegiality. To be part of the same medical group delivering the care brings a level of respect and commitment to that person and their family in the exam room that’s hard to replicate.

3. What are physician’s roles/responsibilities in social media? Should physicians have an online presence? How has this revolutionized the delivery of healthcare and of primary care, especially?

Yes.

I don’t know if any revolutioneering has happened yet. As I posted previously about what family medicine is, a specialty of depth about a person, a family, a community, this is a specialty whose outlook is tailor made for social media. We have unlimited curiosity about the world around us, we don’t want to talk as much as we want to listen. I might go as far to say that all physicians using social media effectively, regardless of specialty, have some of these traits; I invite people to compare and contrast though. It’s the beauty of the medium, you can compare and contrast – it’s their feed.

4. What are some innovative programs and organizations that are working towards improving community health? In what ways is this being accomplished? What are remaining barriers?

Too many to list. I’m going to use this bit of digital space to dialogue about organizations like Capital Bikeshare (@bikeshare), Washington Area Bicyclist Association (@wabadc), Black Women Bike DC (@BWBDC), AmericaWalks (@AmericaWalks), CommunityCommons (@CommunityCommon), GirlTrek (@GirlTrek), your local Department of Transportation.

These are just some that I’ve interacted with in the last few weeks – they are all working towards improving community health. They want to work with doctors. And we want to work with them. Pick your passion in health, there’s someone in your community that has it too and will love to see you there with them.

Possibilities are limitless. What barriers? All that’s needed is some imagination. Let’s just say that “MD” stands for “Maximum Diversity” in working to improve people’s lives.

5. For a student interested in primary care, what would you suggest one do with elective rotations? Are there some areas of medicine that will be more useful than others down the road?

HAVE FUN. The Dean of my medical school said to us, “when I get reincarnated, I’d like to be a 4th year medical student.”

By HAVE FUN, I don’t mean, don’t work hard. I also don’t mean “this is the last time you’ll enjoy your life” – believe me there are non-stop fun times ahead.

I mean, find those experiences that you can access as a medical student because you may be mobile, physically, emotionally, you dream about checking something out. I did a rotation at CDC, at National Library of Medicine (where I fell in love with Washington, DC, and couldn’t shake it even 13 years later…). Tweet people, send them e-mails, many of them will write back and say, “yeah, come on down.” Go.

6. Is there anyway to counteract the ever-shortening periods of time we spend with an individual patient or is that just a necessary byproduct in the mission to improve health on a population level?

YES. Never tolerate anything you think of as a “necessary byproduct.”

Who decided that fulfilling your mission to improve health means that you have to sacrifice your own? There are emerging models – check out Group Health Cooperative’s medical home: The Group Health Medical Home At Year Two: Cost Savings, Higher Patient Satisfaction, And Less Burnout For Providers

Don’t let the future be handed to you. Own it. I am counting on you to imagine the medical practice of your dreams and turn it into reality. You’re not actors in a play, you’re the screenwriters. I alluded to this in my presentation at the ONC 2011 annual meeting. Check it out.

7. Could you talk about the KP HealthConnect system; how it works, why it’s successful, room for improvement?

I could, but I fear this post would be even ridiculously longer than it is already.

Why don’t I just sum it up in 4 words:

4.1 million members online.

8. Best practices for engaging patients in their own health? How do you motivate patients to get active? What is the doctor’s role in promoting engagement versus the community’s role?

I want to clarify what “engagement” means. If it means “the patient is listening when the doctor talks,” that’s not a role that interests me.

If it means, “we listen to the patient, their family, their community, society” that’s the role. As my mentor David Sobel, MD (@KPHealthyFun) says to me, “everyone is motivated, Ted.” They are. I bet you won’t meet a person in your life who hopes to be sick, in pain, unable to be a person, citizen, brother, sister, mother, father, daughter, son.

It’s going to be hard sometimes, because you’re going to be tired, stressed, depressed, happy, sad, but just try it. Sit on your hands and listen 10 seconds longer than you think you should. With your ears AND your eyes.

9. For med students interested in community health, preventative care, family medicine, and public health, what are organizations or activities that you recommend we get involved with to continue exploring? Looking back, what were key experiences you had during your training?

That’s as varied a list as there are people. I did something wierd in retrospect, I interrupted medical school for a year and got a public health degree. It was life changing in a way. In another way it threw me off because I hopped of “the track” of medical education, and after that it always felt like a game of catch up. Then again, I was never going to be on the track, talk to Regina Holliday (@ReginaHolliday) about that.

10. In your opinion, what has been the greatest innovation in medicine over the last 5 years and looking forward, what area has the most opportunity for improvement (communication, technology, education, information tech, social media, etc)?

Phew, easy answer time!

Listening.


Do Medical School Deans see social media in the future of medicine? I asked Dean Stephen Klasko of @usfhealth if he does.

Stephen Klasko, MD, MBA, Senior Vice President, USF; CEO, USF Health; Dean, University of South Florida College of Medicine (photo source: USF Health)

If you look bad on a big screen, you’ll look bad on a small screen – Stephen Klasko, MD, MBA

Continuing on the discussion about use of social media in health care (Score so far: Doctors on Sermo: no, Medical Student Chad Rudnick at USF Health: yes), I had the opportunity to ask Chad’s Dean, Stephen Klasko, MD, MBA, the Dean of the USF College of Medicine about his thoughts on social media and medicine’s future.

I pulled the quote above from our conversation because it symbolizes the approach that I heard Stephen talk about. He said it when, in 2005, USF Health began podcasting every lecture for its students (you can see their iTunes U channel here – Stephen was the head of the steering committee for iTunes U Health). He told me, “I almost had a faculty revolution,” and as he ticked through all the reasons podcasting made his faculty anxious, the last one was, “because it will look bad on a small screen.” Now he says, the facutly enjoys this ability, “it frees them to teach more creatively.”

As I mentioned in my previous post about USF Health, they reached out to me, in the form of their PR firm, Edelman, so my burning question was, “Why?

Stephen led off with his training, which is as an OB-Gyn and a Wharton MBA. He spoke about the physician acculturation process:

The reason we get what we get is because we’ve adapted our DNA to be rigid, autonomous, hierarchichal, and non-creative.

And with this recognition:

When I took over, I looked at ways to create physicians based on the future instead of based on the past.

and

We don’t do stuff to do it – we look at solving problems, and not in the normal academic way

I had a feeling that the reach-out from Edelman was a signal of the innovative nature of this place. With that in mind, I wanted to know:

What is the attitude of social media among the other 131 Deans of Medical Schools in the United States?

Stephen says it ranges from the “I’ll be darned if I do, because it’s not academic” to “I know that Facebook is being used by medical schools as a way to interact with students*” to some Deans not even knowing that their schools have Facebook pages.

“It’s happening in medical schools, somewhat begrudgingly,” he says, and he points to his age (56), which is among the younger in the Dean community, and the fact that younger medical schools are hiring younger Deans at the outset.

*See the bottom of this post for data about what medical schools are doing with Facebook

Where does USF College of Medicine range in the spectrum of medical schools with regard to social media?

Stephen puts USF at top 10% when counting “resources and amount of time spent on new social media” and top 20 – 25 % when looking at total use of social media including blogs and Facebook.

He points out that resistance has turned into benefit – “Once we got a reputation as a school that does this, educators started saying, I want to come to your school, because my Dean doesn’t get it.”

What’s your opinion about the role of social media in the future practice of medicine, does it have one?

Stephen responds, “It does, it also has some risks. When we did a student panel and asked about having a Facebook page or Twitter for your practice, the consensus was ‘yes, but I’m going to make sure it’s totally separate from my personal (pages).” He says they favored having a structured Facebook/Twitter presence around the wellness and disease states of their patients.

Going a little farther, he said, “It will be absolutely routine that docs have that ability. And we’re actually testing it  – we just created a partnership with a community called the Villages –  a community of 85,000 people. Part of our goal is to connect them in a health point of view with social media.” (see: The Villages joins with USF Health to create America’s healthiest hometown

What about medical schools’ roles in fostering innovation?

This isn’t a question that I asked, it was a point of view that Stephen volunteered.

He said:

As with everything, the last place it will  happen is in traditional medical schools, but I think it will happen around marketing practices , one way of connecting two way between patients and providers which I think has to happen.

I was personally impressed with this admission, I’ll say, because I count myself among the legions of the semi-frustrated around the ability of medical schools to train to future care delivery. When I acknowledged this and asked for detail, he said:

If we don’t do it, entrepreneurs will do it, and not do it as well as we do, and hire us.

I would rather figure out a way for us to do it, with the docs that I know are going to be good and interact with patients and have two-way communication.

I do believe that traditional AMC are the last to exploit it. We tend to be innovative in a lot of ways, but it’s not where we tend to be most innovative.

Thinking beyond curriculum – recruitment

If you look at the marketing groups of most medical schools, they’re older than I am. – I have three men with ponytails, who look more like a gaming industry marketing group than a medical school marketing group.

This also impressed me – in a world that is seemingly locked down to p values, there are ways to innovate, selection being one. I hadn’t thought about this previously.

I finally asked Stephen what he thought the doctors of America could do to help him promote innovation, he said:

It would be great to have a social media / innovation in academic medicine blog. As connected as we are in academic medicine, this is the hardest thing to connect – they are not going to put an article in Academic Medicine about our use of Second Life on Match Day, because we don’t have a p < 0.001 or an n of 1000.

The more doctors can start to create the “I did this in my practice, or I did this in my school – that will be a way of getting some of that excitement.”

I took this as both a nod to the work of so many physicians who are telling the story already in social media space AND the recognition that they will have an impact in medical education, even if it seems day to day that this world is siloed from the rest of the world of innovation that some of us live in.

And…..

….it seems that at least one medical school is less siloed than we think. I have an idea that there are others too. Please speak up in the comments if you are innovating like USF Health or if you’d like to.

In the meantime, thanks to Edelman, and USF College of Medicine Students and leadership for providing a little time and a lot of hope for the future. I offer this blog post as my contribution to the connectedness between schools that isn’t happening in the peer-reviewed literature (yet).

Oh, one more thing, some people might say that a discussion like this, coordinated by a PR firm, is a bit of selection bias for the innovative, that there are no PR firms pitching the un-innovative to be interviewed here. To that I’d say….you’re correct :).

What about future doctors, do they see social media in their clinical future? I asked a few if they do.

In the course of doing research on the future of social media in health care, and hearing from a group of doctors who believe there isn’t one in their practice, I also talked to a few future physicians. Three to be exact, from different parts of the United States, a third year student, a student on the verge of enrolling in a US medical school, and….

Chad Rudnick, (soon to be) MD, University of South Florida School of Medicine

..the one i am writing about here, Chad Rudnick. Chad’s a 4th year medical student at University of South Florida College of Medicine. We got in touch because Edelman pitched me about USF’s use of social media to publicize its Match Day celebration. I got this in an e-mail from Jamie Carracher:

My client the University of South Florida College of Medicine is celebrating Match Day 2011 with a Web 2.0 twist, by sharing the emotion of the moment with friends and family across the world through Facebook, Twitter and Second Life.

I thought this was interesting. In the middle of me hearing the “NO” from practicing physicians on Sermo.com, a top-tier communications firm is representing a medical school, promoting its involvement in the social media space. I had to find out more.

Jamie asked if I wanted to speak to a current student and the Dean of the School, Dr. Klasko. I said yes to both. Dr. Klasko’s interview is happening a bit later, in the meantime, here is what I learned from Chad.

First the most important news, Chad’s matched at his first choice, Miami Children’s Hospital, where he expects to become a pediatrician and educator. Congratulations!

I’m paraphrasing below, so in true social media tradition, I will hope and expect Chad to clarify or add to any discrepancies in my faulty note-taking 🙂

Use of social media by medical students today

Mostly to connect with friends and family and learn about events, Facebook is the primary network of choice. Not really a Twitter user, and reports that a minority of his colleagues are using Twitter.

The other two students I spoke to corroborated this usage pattern.

Use of social media by his medical school to communicate with students

Currently, Chad says that the medical school relies on e-mail to communicate with students. However, there’s also a privately accessible sharepoint site where all the communications can be accessed on demand.

The other two (not USF) students corroborated this usage pattern as well – social media is not dominating school-student communication.

Why is University of South Florida Medical School engaged in social media then?

Chad told me simply, “Dean (Stephen) Klasko, he’s a techie.”  He said that (now former Dean, link updated 01/17/2015) Dr. Klasko tweets ( @USFhealth ), blogs, and has a Facebook page, he keeps USF on the cutting edge.

This combined with the way that USF plans its match day, in a very informal atmosphere see : YouTube – Match Day 2011 Video Invitation – makes social media a fit. “it’s a celebration,” Chad told me, and allowed he and his colleagues to share this special day (when medical students across the U.S. find out where they will train in the specialty of their dreams…) with friends and family across the country. The text messages and phone calls came immediately after hearing of the news on the live stream (see : Kiss me, I matched ).

What is the impression that your Dean creates in his use of social media?

He’s “More approachable” – “we are able to see someone through so many different avenues”

One of the other students (not at USF) did not report this same level of enthusiasm from their medical school leadership (…and I’m sure they don’t have Edelman pitching their social media use, either :)).

Does USF have an official policy for students’ use of social media?

Chad told me he is not aware of a written policy (see data below), however he does recall an information discussion several years ago that was had with his class about posting anything that would violate the privacy of patients cared for.

We’re talking about social media for spreading good news, have you seen social media used for spreading bad news, such as a less-than-favorable rotation/educational experience?

Chad indicated that students have had bad days and sometimes use facebook to vent, as much as anyone who is having a bad day. He’s not aware of any student being reprimanded for their social media use.

One of the other students (again, not at USF) told me that there have been incidents of students reporting on negative aspects of their experience, which did result in action on the part of the school. However, they said that comments quieted down and then would return after some time.

How do you think you’ll use social media in your practice in the future? (this is where the conversation took an interesting turn)

It (social media) will have a place in health care. Those who don’t use it will not be reaching their patients.

and

I will use it (social media) to update my patients. I will use it to enhance the doctor-patient relationship

He connected this to the changing access of people to their health records, thinking about how it will be normal for patient to have 24/7 access to their records, portable, on a thumb drive, as an example, and this supports his idea that:

The more people are involved in their health record, the more they will be involved in their health

(Editorial comment: Chad, you’re in good company…..).

Here’s the interesting part for me – when we started talking about Chad’s future use of social media in his practice, his tone changed, I could hear the excitement, I’ll actually say passion in his voice.

I mentioned this to him, and asked if he was worried that his residency training might delay his ability to act on his intent in this space. To that, he told me that he understood there would be a grandfathering-in (or out) of traditional media, as it would be supplemented and then replaced by new media as his generation becomes the practicing physician community.

Chad told me about a recent debate about the future of health care where there was a discussion about what to do regarding patients using social media. He told me, “we have to embrace it,” and “it’s not going away,” and further reminded me that when he’s in his 40’s, he’ll have been using social media as a physician for 20 years.

Chad’s words reminded me of this quote from our paper, Social Media and the Health system:

“On the basis of current life expectancy, it is possible that an individual over the age of 50 today could be cared for by a physician who is not yet born” – Jack Cochran, MD, Executive Director, The Permanente Federation

The best leaders make people less afraid of the future. With that in mind, I’ll say I was pretty fear-less by the end of our conversation.

Did I mention that Chad’s 25 years old? I don’t think I did –  Chad is 25 years old.

Comments and questions welcome, and thanks Chad Rudnick, Edelman, and University of South Florida College of Medicine for telling your story.

Appendix:

Chad’s bio:

Chad Rudnick is a 4th year medical student at the University of South Florida.  Originally from Boca Raton, FL, Chad has a Bachelors of Health Science, Cum Laude, from the University of Florida.

He has been active in the AMA, FMA, and Hillsborough County Medical Association (HCMA) since his 1st year at the COM, where he has been serving as the HCMA delegate for the USF COM for the past 4 years.

Chad has co-authored several clinical research publications and is an active contributing author to The Bulletin, the HCMAs magazine where he writes a column titled, “Medical Student’s Perspective.”

Additionally, Chad recently worked with the American Cancer Society on their “Pass The Buck” campaign, where he represented the medical students from the State of Florida, urging support for legislation raising the tobacco tax in Florida.

For the past 2 years, Chad has served as the organizer and moderator for the USF COM medical student debate on the future of medicine.

Chad will begin his Pediatric Residency at Miami Children’s Hospital this July and will continue to be an active member and voice in local and state politics.  Chad believes that he is a better physician because of his involvement with organized medicine and hopes that current and future generations of physicians also become involved and allow organized medicine to help them better serve their patients.

Data on medical school social media policies, click to enlarge: