medicine.io: Recent Episodes

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In this episode, Josh follows up on his approach to evaluating residencies. He talks about looking at board pass rates and the tricky proposition of asking about accreditation status. Jason and Josh then get into a snarky blog post Josh wrote about a recent study evaluating the value of infectious diseases doctors.

Links for this episode:

• American Board of Pediatrics | ABP Pass Rates 2010 - 2012
• Accreditation Council for Graduate Medical Education (ACGME)
• ACGME Accreditation Status database
• ID Week
• Josh’s tweet heard ’round the ID world (well…the few peds ID docs that follow him)
• Infectious Diseases Doctors Find In Study That Infectious Diseases Doctors Are Great | Josh’s Blog
• Jason’s response to Josh’s post
• IDSA/Avalere Study Demonstrates the Value of the ID Specialist | IDSA News
• Infectious Diseases Specialty Intervention is Associated with Decreased Mortality and Lower Healthcare Costs | Clinical Infectious Diseases (the study that set everything off)
• An Introduction to Propensity Score Methods for Reducing the Effects of Confounding in Observational Studies
• Dartmouth Atlas of Health Care

A programming note—medicine.io will soon move to a new home under a new name. This new feed is not setup yet, but our next episode will be the last one hosted here. We will include links and everything to follow along at the new location. We apologize for the transition.

Thanks for joining us this week! Questions or comments for Josh and Jason? Drop us a line using our feedback form or on Twitter.

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In this episode, Josh and Jason do a remote episode and discuss the CDC's recent report on antimicrobial resistance. Josh then picks Jason's brain about how best to evaluate a residency. Jason is not very helpful (only because it's difficult to evaluate a residency program).

Links for this episode:

• IDWeek 2013
• SXSW Eco | Fighting Superbugs on the Farm
• NY Times | Antibiotic-Resistant Infections Lead to 23,000 Deaths a Year, C.D.C. Finds
• CDC | Threat Report 2013 - Antimicrobial Resistance
• KQED | Antibiotic Use in Livestock Tied to Drug-Resistant Infections
• Pew Charitable Trusts | #36years Later and We're Still Waiting for Antibiotic Action

Thanks for joining us this week! Questions or comments for Josh and Jason? Drop us a line using our feedback form or on Twitter, Tumblr, or Facebook. Don't forget to rate us in iTunes!

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Josh and Jason talk about clinical practice guidelines. They discuss the role of guidelines, difficulties developing them, their length, standards, and design factors.

Links for this episode:

• Digital Doctor Podcast | Episode #19 - Guideline Apps
• iTunes | iGuidelines
• Guideline Central
• iTunes | Guideline Central
• Pediatrics | Impact of a guideline on management of children hospitalized with community-acquired pneumonia
• IDSA | 52-page clinical practice guideline for community-acquired pneumonia in children
• National Guideline Clearinghouse
• IOM | Clinical Practice Guidelines We Can Trust
• Children's Mercy | Community-Acquired Pneumonia Clinical Practice Guideline
• Design Principles for Clinical Practice Guideline Development
• Joint Commission | Core Measure Sets

Thanks for joining us this week! Questions or comments for Josh and Jason? Drop us a line using our feedback form or on Twitter, Tumblr, or Facebook. Don't forget to rate us in iTunes!

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Josh and Jason discuss taking the second part of board exams for medical students (USMLE Step 2), the new maintenance of certification program from the American Board of Pediatrics, the complex payment system based on RVUs (relative value units), and how we measure and improve our performance as clinicians.

Links for this episode:

• USMLE Step 2 Clinical Skills
• USMLE "Irregular Behavior"
• USMLE Step 2 CS scoring
• Wikipedia | Internal Validity
• Wkipedia | External Validity
• USMLE | FAQ "How do I interpret my scores?"
• Wikipedia | Computerized Adaptive Testing
• American Board of Pediatrics | Maintenance of Certification
• WSJ | Hospitals Prescribe Big Data to Track Doctors at Work
• Wikipedia | Relative Value Units
• NY Times | How One Small Group Sets Doctors’ Pay
• Slate | The Hidden Public-Private Cartel that Sets Health Care Prices
• New Yorker | Coaching a Surgeon [by Atul Gawande]

Questions or comments for Josh and Jason? Drop us a line using our feedback form or on Twitter, Tumblr, or Facebook. Don't forget to rate us in iTunes!

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After a short hiatus, Josh and Jason return this week to discuss the surgical rotation for medical students, the release of their iPhone app for clinical practice guidelines, and aseptic hand techniques in surgery and the clinics.

Links for this episode:

• Josh's Blog | Worst things to do in surgery as a med student
• iTunes App Store | iGuidelines
• The Verge | Apple announces iOS 7, 'biggest change' since the introduction of the iPhone, coming this fall
• iMedicalApps | How a medical student partnered with a hospital to create an evidence based guideline app
• iTunes App Store | CAP Guideline
• Children's Mercy | Clinical Practice Guidelines
• Intermountain | Care Process Models
• YouTube | A Comprehensive Guide to the Surgical Scrub
• Atul Gawande | The Checklist Manifesto
• Wikipedia | Crew Resource Management

Questions or comments for Josh and Jason? Drop us a line using our feedback form or on Twitter, Tumblr, or Facebook. Don't forget to rate us in iTunes!

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In this week's brief episode, Josh and Jason tackle antibiotic use in agriculture, TEDMED and the smartphone physical, and touch on physical diagnosis.

Links for this episode:

• house.gov | Rep Waxman to introduce legislation to monitor antibiotic use in animals
• Food Safety News | Slaughter and Waxman introduce bills to gather more antibiotics in ag
• White Oak Pastures
• Twitter | Rock Harper
• Washington Post | Fat Shorty’s to open Thursday with rattlesnake and elk sausages on the menu
• house.gov | Slaughter introduces Preservation of Antibiotics for Medical Treatment (PAMTA) Act
• IMDB | The West Wing
• Wikipedia | The West Wing
• TEDMED
• AliveCor
• Welch Allyn iExaminer
• The Smartphone Physical
• MedGadget | A glimpse into the smartphone physical
• Huffington Post | The smartphone physical: checkup of the future?
• TEDMED | Smartphone physical debuts at TEDMED 2013
• The Digital Doctors | OpenEyes
• Robert Centor MD
• number needed to treat | Dr Centor on improving diagnosis to reduce costs
• number needed to treat | The impossible workload for doctors in training
• Amazon | Evidence-Based Physical Diagnosis

Stay up-to-date on everything medicine.io by following us on Twitter, Tumblr, or Facebook and don't forget to rate us on iTunes!

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Josh and Jason continue to debate solutions for efficient intrahospital communication and dive head-long into the resident work hour restriction controversy.

Links for this episode:

• CNET | Apple's iMessage encryption trips up feds' surveillance
• qliq
• MediGram
• Pebble
• The Wirecutter | The best smartwatch right now is the Pebble, but honestly, they’re all kind of crummy
• JAMA Internal Medicine | Effects of the 2011 Duty Hour Reforms on Interns and Their Patients
• Robert Centor MD | Do shorter work hours have an impact on internal medicine training
• JAMA | To Isaiah

Questions or comments for Josh and Jason? Drop us a line using our feedback form or on Twitter, Tumblr, or Facebook. Don't forget to rate us in iTunes!

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This week, Josh and Jason join Ed Wallit, Stevan Wing, and Wai Keong Wong from the Digital Doctors podcast to discuss digital literacy among physicians and the growing importance of technology in the practice of medicine.

Links for this episode:

• The Digital Doctors podcast
• Twitter | @DoctorNatasha
• NBC Nightly News | Checking in with patients via text
• KCUR | A Text A Day Keeps The Doctor....In Touch?
• Cerner
• Wikipedia | EMIS
• Escape Fire - The Fight to Rescue American Healthcare
• Commonwealth Fund | Escape Fire - Lessons for the Future of Health Care
• Paul Levy | Not Running a Hospital blog
• OpenEyes
• YouTube | Wai Keon Wong's interview with Mr Bill Aylward

Have comments or corrections? You can always reach us through our feedback page and help us out by rating us in iTunes!

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Josh and Jason delve into the difficulties with work-life balance seemingly inherent in medicine, the moral obligation of a physician to primarily practice medicine, and they briefly touch on the state of healthcare in the United States.

Links for this episode:

• Children's Mercy Hospitals Employee Discovery Series podcast
• Escape Fire: The Fight to Rescue American Healthcare
• Time | Bitter Pill: Why Medical Bills Are Killing Us
• CNN | Nightmare Bacteria
• Wikipedia | Don Berwick
• YouTube | 1999 IHI National Forum by Don Berwick
• Atul Gawande | The Cost Conundrum: What a Texas Town Can Teach Us About Healthcare

Have comments or corrections? You can always reach us through our feedback page and help us out by rating us in iTunes!

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This week, Josh and Jason respond to criticisms that doctors should not learn how to code and discuss IBM's Watson and it's potential impact on medicine.

Links for this episode:

• Code.org
• Code.org | What most schools don't teach [video]
• Scratch
• Code School
• Treehouse
• TheraDoc
• YouTube | IBM Watson Demo - Oncology Diagnosis and Treatment (2 min)
• CBS News | IBM supercomputer Watson now being offered to doctors to diagnose patients
• The Economist | Doctor Watson
• Forbes | IBM's Watson Gets Its First Piece Of Business In Healthcare
• The Verge | IBM's Watson joins doctors in fighting lung cancer with cloud-based medical app
• The Atlantic | The Robot Will See You Now
• The New Yorker | The Truth Wears Off
• Wikipedia | Anchoring
• Infectious Diseases Society of America | Clinical Practice Guideline for the Use of Antimicrobial Agents in Neutropenic Patients with Cancer
• PBS | Smartest Machine on Earth
• Framingham Heart Study
• TED | Abraham Verghese - A doctor's touch
• Skyfall
• Luck Laboratories | The Business of Bond

Let us know what you think about the show using our feedback page and help us out by rating us in iTunes!

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Josh and Jason briefly discuss the big events in Kansas City this past week, another IRB issue, even more on secure messaging, and whether or not doctors should learn how to code (as a response to the Digital Doctor podcast this past week).

Links for this episode:

• NY Times | Gas explosion ignites Kansas City restaurant
• Kansas City Star | Surveillance video shows JJ's explosion
• Kansas City Star | JJ’s fundraiser planned for Saturday
• Doctor Natasha | The Good: a rough week in KC
• Wikipedia | Meta-analysis
• medigram
• TechCrunch | Y Combinator Demo Day Session 1 Winter 2012
• iMedicalApps | Medigram app allows HIPAA compliant group text messaging between doctors
• Digital Doctor | Episode 7 - Learning to Code
• CodeSchool
• The Atlantic | How I failed, failed, and finally succeeded at learning how to code

Drop us a line using our feedback page and help us out by rating us in iTunes!

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Josh and Jason debate the optimal episode length for medicine.io and then dig deep into the juicy issue of Institutional Review Board approval for quality improvement projects.

Links for this episode:

• Wikipedia | Institutional Review Board
• Wikipedia | Tuskegee Syphilis Experiment
• US Holocaust Museum | Nazi Medical Experiments
• Dept of Health and Human Services | Belmont Report
• Wikipedia | Retrospective Cohort Study
• Pediatrics | Impact of a Guideline on Management of Children Hospitalized With Community-Acquired Pneumonia
• Institute for Healthcare Improvement
• HHS Answers | Does IRB review of a quality improvement project that is also non-exempt human subjects research always need to be carried out at a convened IRB meeting?
• Academic Medicine | Should Quality Improvement Projects Require IRB Approval?
• JAMA | Determining When Quality Improvement Initiatives Should Be Considered Research Proposed Criteria and Potential Implications
• Wikipedia | Cytochrome P450
• Centers for Medicare and Medicaid | Clinical Laboratory Improvement Amendment (CLIA)
• The Digital Doctor podcast | iTunes link

To settle the episode length debate, please leave us your opinion on our feedback page or send us a message on Twitter and don't forget to rate us on iTunes.

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Jason talks about living the dream in his medical career. Josh goes into too much detail further discussing the security of text messaging but uncovers an interesting aspect of HIPAA and Jason gives an excellent explanation of professionalism and social media.

Links for this episode:

• JAHIMA | HIPAA Compliance for Clinician Texting
• Apple | Mountain Lion Available in July From Mac App Store
• Matthew Green | Dear Apple: Please set iMessage free
• The Digital Doctors | Episode 3 - Bleeps | iTunes link
• Twitter | @TheDigiDoc
• KMOV | Some want Mercy Hospital doctor fired because of Facebook post
• ABC News | Doctor’s Digital Quip Causes Online Kerfuffle
• 33 charts | Takeaways from One Doctor’s Facebook Faux Pas
• Twitter | @Doctor_V

Rating us in iTunes helps out the show tremendously and don't forget to leave us a message on our website or Twitter.

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In the third episode of medicine.io, Josh and Jason discuss some feedback from Episode 002, why Josh thinks secure messaging will be a big deal for medicine and the difficulties with written communication. Jason talks about using a podcast to communicate with hospital staff and about the nuts and bolts of antimicrobial stewardship.

Links for this episode:

• Ted Eytan MD
• app.net
• The Verge | Ad-free social network App.net moves from Twitter clone to cloud platform
• Wikipedia | SMS vulnerabilities (text messaging security)
• tent.io
• 5by5 | Hypercritical Episode #88 - John Siracusa explains tent.io
• tent.is
• Wikipedia | Alexander Fleming
• CDC | Antimicrobial Stewardship
• Stanford Center for Law and Biosciences | Antibiotic resistance and the GAIN act
• GAIN act

Drop us a line using our feedback page and help us out by rating us in iTunes!

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This week, Josh and Jason suppress the urge to talk more about themselves and as a follow-up to their appearance with Doctor Natasha on KCUR's "Up to Date" discuss the digital divide in terms of social media and medicine. They also talk about Paul Levy's visit to Children's Mercy and the role empathy and humility play in leadership.

Links for this episode:

• KCUR | A Text A Day Keeps The Doctor....In Touch?
• Wikipedia | Digital divide
• Ars Technica | Rural US Internet: not great, but truly poor in the South
• The Atlantic | The Reason Silicon Valley Hasn't Built a Good Health App
• Institute of Medicine | Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care
• Vector | Could texting patients reduce hospital readmissions? Thinking through an innovation
• Paul Sax | Needed: Something Better than HAART
• Johns Hopkins Global mHealth Initiative
• d+ collab | The Patient Record
• Paul Levy | Not Running a Hospital
• Not Running a Hospital | Inspired at Children's Mercy Hospitals
• Institute of Medicine | To Err is Human: Building A Safer Health System
• Institute of Medicine | Crossing the Quality Chasm: A New Health System for the 21st Century
• "These things happen..." clip from the movie, It's a Mad, Mad, Mad, Mad World
• Goal Play!: Leadership Lessons from the Soccer Field
• Ohio Children’s Hospitals’ Solutions for Patient Safety

Please provide feedback via our website and rate us in iTunes!

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In the inaugural episode, Josh and Jason talk too long about their respective backgrounds, what they are trying to accomplish with this new podcast, and a few ideas about future topics.

Please provide feedback via our website and rate us in iTunes!

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