Seat Belts: What's The Big Deal?

I wonder how often doctors speak with patients about wearing seat belts.  We all know it is important, and most states have a law requiring that a seat belt should be worn. (click here for information about each state’s seat belt requirements).  In a busy clinical practice, talking about preventive care (such as why wearing seat belts is important for safety) is difficult on top of all of the other things patients want to talk about.  But it is important.
The use of seat belts is one of those habits that most people just do.  You get into the car, you put on your seat belt.  It is that simple.  If we don’t get into an accident, then all is fine.  But what happens when we are unfortunate enough to be involved in an accident?
A recent teenager death from an automobile accident in an Indianapolis suburb hit home to me as a physician who cares for teens.  The teenager who died was not wearing a seat belt.  Over the years, I have also cared for patients who likely would have died were it not for wearing a seat belt.  Their stories are compelling.  In addition, my oldest daughter was in a car crash a few days ago.  She had one minor bruise, but otherwise was unharmed physically.  She was in an age-appropriate booster seat, wearing her seat belt.
It makes me think: why are people choosing to not wear a seat belt?  Seat belts save lives.  So do air bags.  Research clearly demonstrates this.  The use or lack of use of seat belts is a public health issue, which has the potential to impact anyone, regardless of socioeconomic status.
This issue has certainly impacted my family and my practice.  Please, if you get into a car, take the few seconds it takes to click in your seat belt.  As a physician who spends time providing advice to patients, this one is a no-brainer: wear your seat belt when you get into a car—every time, with no exceptions.  It may save your life.

Medical Administrators – Should They Still Care For Patients?

I have been relatively absent from social media for the past week or so.  I have been doing inpatient duties on a general medicine service, and really enjoy working with medical students, interns, residents, pharmacists, and inpatient floor nurses.  It has been a wonderful opportunity to experience the day-to-day activities involved in hospital medicine, and of course, to see and care for patients.
The time on the inpatient service is demanding, both physically and emotionally.  Managing ill patients, long hours caring for complex patients and updating their families leave little time for my other duties in overseeing a CME office and a residency program.  I am trying my best to juggle all of these duties, but for now, the patient care priorities do come first.
As I was arriving one day this week, I saw the chair of another department coming in, and mentioned that I was on service doing inpatient work.  He remarked: “So good to hear that you are continuing this great work, and that you are still actively involved in patient care.  Keep it up!”  That made my day.
So I have been pondering this: should physicians who have major administrative duties and oversee programs, and thus have major time devoted to such activities, still care for patients?  Should they still remain clinically active in order to have “street credibility” with their mostly clinical colleagues? 
I think the answer to this is “yes”.  As busy as it is, I still believe that it keeps me fresh.  It allows me the opportunity to reflect on why I went into medicine in the first place.  It allows me to still remember what it is like to talk with a worried family member about a loved one, to see the gradual changes when a patient improves from hospital admission to discharge.  It allows me to also see the trainees doing what we want them to do: learn to care for patients.
The more I become involved in overseeing administrative programs, the less time I can devote to direct patient care.  But I still really enjoy doing the day-to-day patient care, and working with trainees as they learn the art and science of medicine.  I still haven’t forgotten the old adage by Francis Peabody: “The secret in the care of the patient is in caring for the patient.”

Medical Conferences: What Are Your Take Home Points?

I attended a local conference today sponsored by our Department of Pediatrics and Riley Hospital for Children.  Many of our residency graduates, especially those who live and work locally, return for this meeting.  It really is great to see our graduates and what they are up to.  I enjoy hearing about how they have transitioned to practice, and learning about their own successes and challenges.
This particular year, I was not a presenter, nor did I run any workshop.  I went to this conference strictly to learn.  It was simply wonderful to do so.  The day started off with a dynamic visiting speaker reflecting on the state of well child visits and potential innovations around how to be more effective with these, especially given the changes in medicine that are occurring and will continue to occur.
One might think that this topic is not all that interesting (which the speaker himself even acknowledged).  Plain and simple, I was inspired!  It brought me back to why I chose to go into medicine in the first place: to make a difference. Other extremely well-presented sessions reminded me of things I should be doing when encountering patients with specific conditions.  A lunchtime talk on mentoring solidified a successful day for me (and that was only halfway through the day!).  Other great “high-yield” topics in the afternoon piqued my interest as well.
When some people come back from conferences similar to this one, they realize that while the conference was wonderful, there is still a stack of paperwork that needs to be completed, that there is more work to be done, patients need to be seen, and emails must be answered.  I also have all of those things looming over me.  But I also gained a sense of purpose, connectedness, and excitement for the future of medicine from the conference.  In addition, I learned some new things, was reminded of things I should already know, and also heard about changes coming in the future.
What do you get out of going to conferences besides the acquisition of information?  What other “informal curriculum” things get you jazzed up, and how can conference organizers effectively capture that for other attendees?  I am curious if others see this similarly or differently.

A Medical Educator Joins Social Media: One Year Later

I just realized that yesterday was my one-year “anniversary” for joining Twitter.  Wow, what a ride it has been.  I have learned so much in this short year.  Here are a few take-home points:
1.      If physicians and other health care professionals are not becoming involved in social media, they are missing out on a “place” where many of the patients already are.
2.      Despite #1, there are late adopters who feel that social media is a “waste of time” for physicians.  That is ok.  Forcing them to “do social networking” will not be fruitful.
3.      Social media is a fantastic way to meet other like-minded individuals who have similar interests.  I never would have met a great group of people (some in real life) had I not joined social media.
4.      Patients crave information about their health.  If they want it via social networking routes, we should offer it to them.
5.      There is a lot of mis-information floating around on the internet.  It is a duty of physicians to combat this and provide correct information.  I fail to understand why physicians don’t embrace this more: it is advocacy in the truest sense!
6.      If you decide to join social media, start slow, but start.  It will take a while, like riding a bike is not learned in 15 minutes.
7.      Do not let social media take over your life.  The important things (family, friends, etc.) are still the important things, so don’t lose the priorities.
8.      Push the envelope.  It is time for curricula in social media within medical education to be formally written, and also to be disseminated.  Policies or guidelines are one thing, but curricula are another.
9.      There are many “tools” to make it easier to integrate social media into “what you do”.  Pick one or two, and use them.  It will make the process less overwhelming.
10.   Have fun!  There is some great learning, and in addition there are some fun people out there, and I am a better person for having met them virtually.

For Your Health

Today’s post is a little off the usual theme of Medical Education.  But then again, maybe it isn’t.  Why are those who do medical education involved in teaching others?  Among other things, because they enjoy the love of teaching.  I certainly do.  Today’s post is teaching by doing.
Yesterday, I ran in the Indianapolis “Mini-Marathon”, a 13.1 mile half marathon which is supposedly the largest half-marathon in the United States.  Wow, what an incredible day.  I have run it before, but there was something different about yesterday.
I got there early, after waking up before my alarm woke me up.  I stretched, got my stuff all ready to go (including having my phone with me, as well as gel packs), and was ready to go in my corral early.  I didn't see as many people that I know as I usually do.  It was great to see Dan Fulkerson, one of our Neurosurgeons.  In the corral, just before the start, I found another one of my Riley Hospital colleagues, Dr. Scott Walker, a pediatric anesthesiologist, and met his family.  An incredible sight of the race just before the start is here.
In the past, I have tended to come out too quickly, and I was determined not to do that again.  The first mile was just about where I wanted to be, and the next two were perfect.  I was feeling great at this point, and was on track to meet my goal.
For me, the nemesis has been the race track, which is just before mile #6 until just after mile #8.  I was determined not to slow down on the track.  I made it to the Yard of Bricks at a time which was perfect for me.  I felt really good at this point. 
Then I just plain petered out, along with many other runners.  I walked the water station at the end of the track, and just couldn’t recover.  The heat had gotten to me, and I simply couldn’t go any faster.  My legs were aching, along with my feet.
My GPS timekeeper shows the times from Mile #9 through the end with slower times during each consecutive mile.  This was a bummer, but I think that the lack of long training, and the heat took its toll on me.  But the atmosphere was just incredible.  It was wonderful seeing people running for causes, running for loved ones, running for their own health, or running "just because."  This alone is a reason to run the Mini.
For example, I saw military personnel decked out in full gear, with heavy backbacks, who did the entire race with this gear!  I saw a man who had an obvious stroke but who kept trudging along (actually passing me!).  I saw kids pushing their parents on.  I heard so many words of encouragement and songs from the many bands and cheerleaders along the way.  My favorites: the Circle City Cloggers, and the high school students decked out as Christmas ornaments!
So why have I continued to run the Mini-Marathon?  I am certainly sore afterwards.  It definitely takes a while to train for this (lesson for next time: train a bit longer, focusing on the longer distances).  Is it the thrill of running?  Is it the excitement?  Is it all of these things, plus some unknown factor?
Who knows?  I’m not sure, but I just signed up again for next year!  Here’s to my health and yours!
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