Physicians And Health Care Professional Are You Ready For The Revolution Part I

What You Didn’t Learn in Medical School and What You Need to Succeed in the 21st Century

Information Technology

As quietly as it’s kept, or maybe it’s not so quiet but you are overwhelmed by it, there is a revolution going on in front of your nose. That revolution is the way we learn and access information. As physicians we know that more and more health information will be obtained and delivered by the internet. Although 50% of physicians have websites for their practices, and 70% of physicians access the web for medical and prescribing information, only 10 to 12% use the web for continuing medical education (CME), continuing professional education or personal development. However, with the cost of traveling for CME becoming more prohibitive, I predict that more physicians will use the web for CME. And as physicians desire to expand and transition their careers, more will access the internet for these educational needs as well. But, I think many of us are unaware of the unlimited education and entrepreneurial opportunities the internet offers.

The capability for obtaining most of our information and education via the web is astounding. In fact, most of the informatio
I need to practice medicine, I now obtain through online publications. I haven’t bought or opened a medical book in several years. I rarely read hard copy medical jou
als except for JAMA. Usually, when I need to know something, including local, national, and world news, I search the web first. The flip side of this is that I do buy hard copy business, novels, poetry, self-improvement, and spirituality books. For these types of books, the act of reading; holding the book in my hands, as I am propped up in bed with pillows, or curled up on the couch, are part of the pleasure. I have over five hundred books in my “library.” However, I have been thinking about purchasing Amazon’s Kindle, the new e-book reader.

Recently, I read that the cost of medical education is increasing 200% and the average indebtedness of medical students is over $135,000. The increase in cost is primarily due to tuition. Interestingly, it is also projected that by 2011 there will be a severe physician shortage. Globally, 4.5 million health care workers are needed. For example in the United States, there are only 4,000 practicing geriatricians but 30,000 are needed. With the cost of medical education rising how are we to bridge the gap and serve the health care needs of society? Perhaps we should look at a different model for medical education that rely less on “bricks and mortar” medical schools and more on the internet and online education.

More universities are offering online education. Online education is considerably less expensive than “bricks and mortar” education. Might it not be possible to teach the core curriculum, the first two years of medical school, in an online format? There could be a virtual classroom where students could log in and listen to the lecture any time of the day or night. Online chats with the instructor and other students could foster community, reinforce learning, and students could do group projects this way. A few days ago I did a CME activity where I was in a virtual classroom. After the lecture, there was a question and answer session via an online chat.

But what about teaching physical diagnosis and basic clinical skills, you ask? These could be obtained with local physicians or hospital where the student lives. These physicians would be credentialed as preceptors and adjunct faculty after appropriate training and credentialing.

Many have questioned the need for cadaver dissection. Virtual dissection, like video games, could be designed to teach anatomy. Perhaps quarterly, students could travel to the “bricks and mortar” school for a long weekend or a week of workshops and class time. This would allow them to interact with classmates and instructors. Of course remote or online education does affect socialization and indoctrination, “the hidden curriculum,” in medical education. But this might not be a bad thing. Allowing students to remain connected to their community and family may decrease stress, depression, burnout, cynicism, and alienation. This type of medical education would be particularly appropriate for primary care specialties.

Third year rotations could still be done at teaching hospitals. However, more emphasis should be placed on outpatient rotations and chronic care rather than hospitalized patients and acute care. Some have suggested that the fourth year of medical school is redundant and perhaps not necessary. Students spend a good deal of time on electives and interviewing for residency. If the electives do not involve direct patient care, perhaps online classes could be substituted as well.

Not only can the web be used for undergraduate medical education and CME, you can also obtain advanced degrees or certificates in business, medical ethics, creative writing, education, and many other areas through online programs, webinars, teleseminars, podcasts, and programs that are a combination of all of these. For example, I just wrote an E-book, From Burnout to Breakthrough: The Physician’s Definitive Guide to Transform Your Personal Life and Career, Rediscover Your Calling, and Launch Yourself into Unlimited Health, Joy, and Success. I learned about writing this E-book through teleseminars and online courses. My career, executive, and life/wellness coach certification was obtained through a combination of teleseminars, onsite workshops, and one-on-one mentoring. Additionally, I am in the process of completing my Master of Fine Arts in Creative Writing. The low residency format i.e. twice a year onsite “residencies” and then email communication with mentors in between was perfect for my busy schedule as a career and wellness coach, practicing physician, wife, and mother.

Teleseminars, webinars, and podcasts are excellent patient education tools. These can be created with minimal extra effort. You can speak and record on your laptop or desktop exactly what a patient needs to know. A tool to record directly onto your computer is www.audioacrobat.com. You download the software, and pay a monthly fee. Minor additional equipment needed are a set of headphones and a microphone. Your audio file can then be easily uploaded to itunes or in an mp3 format that patients can download. Or you can send an audio email to patients reminding them of appointments, side effects of medication, to take their medications, or exercise, the list is endless!

Patients could also be given a one or two gigabyte flash drive of information in digital or audio format that you have developed. At home the patient could download the information and listen to you, or print out the information for reading. You can create video information for patients very inexpensively. An inexpensive video camera or webcam can be purchased online or at your local office supply store. The video can be placed on www.Youtube.com and can also be downloaded as an mp3 or itunes file. Once on Youtube you can direct your patients to the website. For example you could record a video about postoperative care or what to expect after bariatric surgery. And what about giving the patient their health record on a flash drive? Hospitals already give patients their x-rays on CDs. I recently obtained copies of my mammogram this way. Why not put this on a flash drive instead of a CD?

Patients are coming to physician offices armed with information, accurate and inaccurate, that they have gleaned from the internet so why not jump on the bandwagon and create your own correct and timely information. Physicians could also address some of the inaccurate information by providing patient education on their office website, setting up disease specific websites or blogs, and submitting articles to ezines. Yes, updating content on a website or blog does take time. However, a blog post is two hundred words or less. A blog post could be a few points taken from an article you wrote or a presentation you gave. Furthermore, posts need not be entered daily but can be entered twice a week. MSN and yahoo don’t update their articles any more often than this. An excellent book about blogging is Blogwild, by Andy Wibbels. However, you don’t actually need to read a book. You can sign up for a free blog at www.wordpress.com, and follow the online tutorials. Although I don’t have an active blog at this moment, I plan to start one within the next week. Actually, my website, www.physiciansuccessunlimited.com, started as a blog on www.squarespace.com. I had my initial blog up in three hours!

Another option in addition to or instead of a blog, is an email newsletter or Ezine. The newsletter can be sent out once a month or even quarterly. It is approximately 750 to 5,000 words. It can provide information, review office policies, and announce new services. An email newsletter template I use is Constant Contact, www.constantcontact.com. You can also submit articles you have written to ezines like ezinearticles.com. And if you absolutely cannot imagine writing articles you can obtain articles or provide links from your website like webmd.com, medscape.com, the NIH, your specialty society, and ezines that you have examined like ezinearticles.com or bestezines.com, that you think have good content. Patients are grateful for information from a physician they trust. Providing this information for patients also creates loyalty and can generate new patients.

Hiring a virtual assistant (VA), someone adept at administrative tasks, can help with maintaining your website, blog, or sending out your newsletter. These are highly skilled professionals that charge by the hour or month depending on your needs. The good news is that they are independent contractors and their services are tax deductible as a business expense. You could record a blog post or newsletter article and email it to your virtual assistant to post for you. I have an excellent virtual assistant who has helped me with my website and performs administrative tasks that I don’t have time and don’t like to do. They way I found my VA was by submitting a request for proposal on www.vanetworking.com, or you could try www.ivaa.org.

Soon, a traditional website may not be enough. More people will access information from the internet via there cell phones. They will want to download content from your website to their cell. Currently, the files are too large to transfer effectively. However, mobi websites, i.e. www.DrX.mobi, will allow more efficient and accurate downloads. So, in addition to your traditional website, a mobi website will be an essential tool.

Some physicians have electronic medical records in their office and do e-prescribing. Most physicians who have implemented EMRs or EHRs have seen significant increase in efficiency, productivity, and improved financial performance of their practices. Although there are conce
s with HIPAA, more physicians will be communicating with patients via email. Contrary to belief, those that do communicate by email, have not experienced abuse of email privileges by patients. There are a few companies offering virtual consults by phone and email for minor problems like a sore throat, or urinary tract infections.

One more thing, as you contemplate the myriad ways you can incorporate technology into your practice, it is a good idea to start getting domain names for your potential website, blogs, ezines. I usually use www.godaddy.com. A domain name can be had for as little as $1.99. It is a good idea to at least get your name as a domain name. Also as soon as you think of a catchy domain name for your practice, information site, business, or blog, it’s a good idea to get that domain name as soon as possible. Popular domain names get snatched up pretty quickly and you may have to buy your domain name from a reseller at a premium price.

These are just a few ways that information technology and the internet will and can revolutionize medical education and practice. In part II, I will discuss more ways the internet and information technology can be used for personal and spiritual development. In the mean time Jump on the internet, take a teleseminar or webinar, investigate podcasting, create your own blog or ezine, or update your website. It won’t take as much time and energy as you think!nnn n