Cyberchondria: Online Symptom Checking Won't Make You Feel Better

I recently came across this article published in Psychosomatics (from the Academy of Psychosomatic Medicine). Yes, there really is a peer-reviewed journal dedicated to psychosomatic disorders!

The article validates much of what I have observed in my practice of clinical infectious diseases.  Whether it is chronic fatigue, chronic Lyme disease etc, patients with already high levels of anxiety searching for medical information online felt worse after online symptom checking.  In fact, spending greater than 3 hours per day on the Internet for symptom searches resulted in heightened anxiety during the online search and worse anxiety afterwards.

Cyberchondria.

Perhaps we should now recommend that patients with illness anxiety avoid the Internet for illness related medical information.  

Easier said then done.

What Does Excellent Look Like? My (Very Brief) Perspective on Infection Prevention

This article in Academic Medicine caught my eye- What Would Excellence in Health Professions Education Mean if It Addressed our Most Pressing Health Problems?

The authors argue for metrics that assess key principles: matching the population health needs with the production of the right mix of health professionals, ones with the right set of skills so as to impact healthcare spending and quality.

This got me thinking, what does excellent look like for infection prevention?

I am not entirely sure how best to define excellence in infection prevention, however, I know where not to go with it.  Beware of illusory goals and unrealistic soundbites such zero healthcare associated infections.

Perhaps excellence in infection prevention is best described as the relentless implementation of evidence based risk reduction practices, with pragmatism and fidelity, so that they play out in the real world, for all at risk patients, in perpetuity (or until a better strategy arises). 

In other words, excellence in infection prevention is 'good practice' done consistently.

New Strategy: Boycott the Publisher!

University of California Los Angeles

Sometimes we need to think outside of the box.

This paper, published in the Chronicle of Higher Education, reports how the University of California Los Angeles has adopted a new strategy in its effort to negotiate with an academic publishing giant- Elsevier: boycott the publisher!  Consider publishing your papers elsewhere.

Specifically, campus officials have asked UCLA faculty members to consider declining to review and submit articles to Elsevier.

Why?  Money, of course.

The University California system's 5 year open access contract with Elsevier costs a whopping $50 million dollars.  The goal is to hit Elsevier were it hurts the most- its content.

As stated in the article: What they are selling is access to research. If they do not have the research, they have nothing to sell.

Touché

Of course, some argue that this could hurt the promotion and tenure of junior faculty.  There may be a grain of truth to this comment, however, people were previously promoted without open access publishing.

Kicking for a Cause: Richmond City FC 14th Annual Copa Navidad Charity Soccer Game

2018 Richmond City FC Copa Navidad

2018 Richmond City FC White

2018 Richmond City FC Blues

Richmond City FC Old Guard

Old footballers never die, they play in charity soccer games.

Today I was with Richmond City FC at the Annual Copa Navidad charity game. Another close match between Richmond City Blues versus Richmond City White. Later a photo opportunity with some of my old football palls. Unfortunately, due to an injury, I did not play in today’s match. 

More information at www.richmondcityfc.com

Hoy estuve con Richmond City FC en la Copa Navidad en un partido de fútbol benéfico. Fue otro partido peleado entre los blancos y los azules. Más tarde, me saqué una foto con la retaguardia del club. Lamentablemente, debido a una lesión, no pude jugar en el torneo de hoy.

Más información en www.richmondcityfc.com

ID Specialists See More Complex Patients and Now We Can Prove It!

Infectious diseases specialists see more complex patients. The difference is that now we can prove it!

This article published in JAMA Network Open is the 1st to report empiric evidence that the complexity of patients seen by infectious diseases specialists is greater than that of most other subspecialties.  Finally, something to back up our claim.

As the patient complex increases the time and resources required for care also increase.  This is no small detail. A good ID consult takes time and effort.

High complexity, high volume, low pay- modern day Infectious diseases in the current fee for service model. This will not make a good recruitment tool!

If compensation plans could only see things our way we would all be much happier.

Hot off the Press: SHEA Expert Guidance for Infection Prevention in the Operating Room Anesthesia Work Area

I am proud to announce that the SHEA Expert Guidance infection prevention in the anesthesia work area has published. This collaborative project was no small endeavor. Congratulations to all for their diligence and persistence in seeing the project completed.

The full manuscript is available here.

Although the extent to which surgical site and hospital acquired infections emanate from anesthesia interventions is likely low and poorly defined, the risk is not negligible. Along with our colleagues in anesthesia, we delved into controversial areas with the hope of providing sensible, expert guidance on how to minimize infection risk.

We hope that our recommendations will resonate and positively influence our anesthesia colleagues.

The Evolution of the Clinician Educator: All Great But Let's Call it Like it is!

I have hired multiple clinician educators in my institution, all of whom are doing wonderful clinical and academic work.  The academic output by my team is remarkable given the competing priorities of clinical expectations.

I refer you to this recent article on the evolution of the the clinician educator published in Academic Medicine.

The article is insightful and neatly summarizes the role of clinician educators in academic medical centers, particularly the critical role that these faculty play in the dedicated teaching of students and residents.  The clinician educator role has evolved through formal faculty development, educational scholarship in dedicated journals (e.g.  Academic Medicine) and through the appearance of professional societies (e.g. Academic Alliance of Internal Medicine).

I agree with all the above but lets call like it is.

The major and present obstacle to academic success as a clinician educator is the current primacy of clinical RVUs. Until we carve out dedicated time and funding for academic roles such as teaching, education will always be second fiddle.

Budgets and compensation are a reflection of priorities and values- simple as that.

Somen Debnath Visit to VCU: Around the World On Bicycle Tour for HIV / AIDS Awareness!

This visit was truly special.

Today we had the great honor of hosting Mr. Somen Debnath  who is on a personal and spiritual mission to raise HIV awareness.  He is on a 200,000 km, 191 country around the world bicycle tour.  His visit to Richmond, Virginia and the VCU HIV Center marks 155,000 kilometers and 150 countries into the journey.

During his odyssey Mr. Debnath was captured by the Taliban and held for 24 days, was robbed six times, beaten eight times, went through 280+ tires and had his bicycle stolen thrice.  

Along the way he also met thousands and thousands of wonderful people and raised awareness for HIV/AIDS. Somen has not yet lost his enthusiasm. 

Inspirational.

Images from the event are below.

Visit is Somen's website and stunning visual travelogue here.

Start With Why if You Seek to Lead and Inspire

I recently read the book Start With Why by Simon Sinek. The book explores how leaders inspire.  

I have seen many executives who focus on what we do and how we do it (execution).  They do not clearly communicate the "why"-the inspirational core mission.

Effective leaders personify the "why", they talk about it, embody it, preach it and inspire those around them.

The same applies to healthcare.  

Leaders who inspire us to better and safer care, rather than RVUs and patient throughput, will almost certainly have positive outcomes on patients, physicians, nurses and staff. 

So, seek to inspire first. The outcomes will then follow.