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Mental Health, Research, Technology

How social media can affect your mood

How social media can affect your mood

Facebook_10314A close friend engages in a yearly media detox, where for a period of time he limits his time and activity spent on the Internet. He only answers e-mails requiring an immediate response, spends few minutes reading current news and avoids engaging in social media, shopping online or perusing gossip and entertainment sites. Another friend goes on annual eight-day meditation retreats and turns off her phone for her entire stay. Both report that these periodic breaks significantly improve their moods.

Past research supports their personal experience and shows that while many of use social media to feel connected to others, it can also leave us feeling frustrated, lonely and depressed.

A study (subscription required) recently published online in the journal Computers in Human Behavior offers context to these earlier findings and suggests that when we are feeling blue we use social media sites, such as Facebook, to find friends that are also having a bad day, suffered a setback or going through a tough time in their lives.

During the experiment, researchers gave participants a facial emotion recognition test and randomly told them their performance was “terrible” or “excellent” to put them in positive or negative moods. The individuals were than asked to review profiles on a new social networking site. The profiles used dollar sign or heart icons to make users appear successful and attractive or unattractive and unsuccessful. All profile photos were blurred and the status updates were relatively mundane and similar in tone. PsychCentral reports:

Overall, the researchers found that people tended to spend more time on the profiles of people who were rated as successful and attractive.

But participants who had been put in a negative mood spent significantly more time than others browsing the profiles of people who had been rated as unsuccessful and unattractive.

“If you need a self-esteem boost, you’re going to look at people worse off than you,” [Silvia Knobloch-Westerwick, PhD, co-author of the study] said.

“You’re probably not going to be looking at the people who just got a great new job or just got married.

“One of the great appeals of social network sites is that they allow people to manage their moods by choosing who they want to compare themselves to.”

Previously: Ask Stanford Med: Answers to your questions on the psychological effects of Internet use and Elderly adults turn to social media to stay connected, stave off loneliness
Photo by Paul Walsh

Mental Health, Neuroscience, Technology

What email does to your brain

What email does to your brain

man yellingUpdated 10-2-14: A follow-up post, with tips on how to manage your inbox, can be found here.

***

10-1-14: Have you ever been in a situation in which you were feeling great until you received an email out of the blue that completely upset your day? How does it feel to receive 30 such emails first thing in the morning? There’s a reason why: Research shows that just looking through your inbox can significantly increase your stress levels (see research described here).

Why is this? Let’s start by defining stress. Stress is the experience of having too great a task to accomplish with too few resources to meet the demand. In the past, for our ancestors, this stress might have looked like meeting a hungry wild animal in the jungle. Today, however, it takes on a much more simple, yet equally powerful form: an inbox. Email overload is just another way in which we experience that there is too great a task (the huge list of to-dos) to handle. In the study mentioned above, email overload had a lot to do with the stress response as measured psychologically and physiologically through heart rate, blood pressure and a measure of cortisol (the “stress hormone”).

Is it just the amount of emails that lead to stress though? There’s another element that we are forgetting. The emotional impact of each email. Think about it: Usually, in our email-less past, we would experience maybe one highly emotional event a day or maybe two or three at the most, e.g. a confrontation with a colleague, perhaps a spat with a spouse, and/or a phone call from an angry neighbor. Our stress response is evolved to handle and recover from a small number of stressful situations but not a whole host of them. Unless we live in unusually extreme situations such as warzones, for example, our life usually doesn’t have frequent and sequential stressors thrown at us.

Today, however, just sitting down at our desk to check our email with a cup of coffee can bring on a deluge of emotional assailants. Between 30-300 different emotional stimuli are delivered to you within the span of minutes. From an email from your boss asking you to complete a task urgently, to a passive-aggressive message from a family-member, to news from a colleague that he’s out sick and you have to take over his workload. One hour of email can take you through a huge range of emotions and stressors. Sure, you can get happy emails too – photos of your nephews, someone’s marriage announcement – but unfortunately, research on the negativity bias shows that our brain clings more to the negative and they don’t always balance out.

That’s when our emotional intelligence is impacted. We know that when our stress response is activated, the parts of our brain that respond with fear of anxiety tend to take over, weakening our ability to make rational choices and to reason logically this study). You may be stressed; what’s more, your own ability to respond appropriately is impacted. We know that our emotions impact the way we act. You’re going to reply with a different tone if you’re upset (even at someone other than your email recipient) than if you’re not.

Have you ever pressed “send” only to regret it moments later? Don’t blame yourself. Research shows that getting depleted because you have too much on your plate reduces your self-control. For example, it can make you take more risks when maybe you should be more cautious (e.g. this study). It’s harder to have a say over our impulses when there’s just too much going on. As in too many emails, with too many different messages leading to increased stress and emotional overload.

When you’re doing a million emails – all about different topics and requesting you for different things, you are, by definition in a situation of overwhelmed multitasking. And multitasking, research shows, leads to lower productivity and makes you lose a lot of time out of our day!

So what’s the answer to the assailment of email on our lives?

Before you contemplate moving to a farm, selling your smartphone on Ebay, raising chickens and goats and cutting technology out of your life forever despite your love of selfies – WAIT, there’s a solution. Think about it – email didn’t exist 10 years ago! That means that there is a way to undo the madness. I’ll share a number of tips in my next post… Stay tuned.

Emma Seppala, PhD, is associate director of Stanford’s Center for Compassion and Altruism Research and Education and a research psychologist at the School of Medicine. She is also a certified yoga, pilates, breath work and meditation instructor. A version of this piece originally appeared on her website.

Photo by bark

Applied Biotechnology, Bioengineering, Events, Medical Education, Stanford News, Technology

Stanford physicians and engineers showcase innovative health-care solutions

Stanford physicians and engineers showcase innovative health-care solutions

scholar-poster

A “breathalyzer” that noninvasively determines if patients have unsafe levels of ammonia in their blood. The discovery of a previously approved drug that also fights the Dengue virus. A smartphone-based eye-imaging system that can be used to diagnose vision problems remotely.

These are a few of the 40-plus inventions and clinical solutions presented at the first annual Spectrum Innovation Research Symposium, held last Friday at the Stanford School of Medicine. The event demonstrated the power of bringing together teams of physicians, bioinformaticists and engineers to apply new technologies and ideas to challenging medical problems. Also showcased were budding physician-scientists supported by the Spectrum KL2 and TL1 clinical research training awards. (In the photo above, Colleen Craig, MD, an endocrinology fellow, describes a novel treatment that she’s developing for gastric-bypass patients who suffer from severely low blood sugar.)

The buzz is that it’s going to be a good year for health-care breakthroughs

Spectrum, the recipient of Stanford’s NIH Clinical and Translational Science Award, annually gives up to $50,000 to investigator teams for year-long projects in the areas of drug discovery, medical technologies, predictives/diagnostics, population health sciences and community engagement. This program also provides these teams with training and mentoring to help them move their ideas rapidly from bench to bedside and into the community.

“These modest pilot awards have been immensely successful in stimulating innovative ideas across the spectrum of translational research,” said Spectrum’s director, Harry Greenberg, MD. “They have lead to new inventions that promote individual’s health, new ways of improving the health of the populations and new efforts to assist our surrounding community on health issues.”

As this year’s grantees were rolling up their poster presentations, next year’s scholars were rolling up their sleeves to finish their 2014-15 Spectrum grant proposals, which are due in a few days.

It’s been a pivotal year in medical technology, with the launch of an unprecedented number of game-changing inventions, such as the Mini-ION, a $900 USB-powered DNA sequencer, and Apple HealthKit, a health-and-fitness dashboard and developer kit. In the coming year, these will provide Stanford scholars with amazing technology platforms from which to launch medical solutions that are better, faster and cheaper.

“We are in the middle of amazing biomedical innovation here in Silicon Valley,” said Atul Butte, MD, PhD, and faculty director of the diagnostics/predictives program. “Spectrum enables us to fund the earliest of early technologies, more risky than even the usual angel investments, but with higher potential impacts. In the end, this gets technologies to patients and families that much sooner.”

Because of this, anticipation among the grant-approval committee members at the symposium was high — the buzz is that it’s going to be a good year for health-care breakthroughs.

Previously: Spectrum awards innovation grants to 23 projects, Stanford awarded more than $45 million to spur translational research in medicine, As part of annual tradition, budding physician-scientists display their work, and New class of physician-scientists showcase research
Photo by Kris Newby

Clinical Trials, Immunology, Pain, Research, Stanford News, Surgery, Technology

Discovery may help predict how many days it will take for individual surgery patients to bounce back

Discovery may help predict how many days it will take for individual surgery patients to bounce back

pandaPost-surgery recovery rates, even from identical procedures, vary widely from patient to patient. Some feel better in a week. Others take a month to get back on their feet. And – until now, anyway – nobody has been able to accurately predict how quickly a given surgical patient will start feeling better. Docs don’t know what to tell the patient, and the patient doesn’t know what to tell loved ones or the boss.

Worldwide, hundreds of millions of surgeries are performed every year. Of those, tens of millions are major ones that trigger massive inflammatory reactions in patients’ bodies. As far as your immune system is concerned, there isn’t any difference between a surgical incision and a saber-tooth tiger attack.

In fact, that inflammatory response is a good thing whether the cut came from a surgical scalpel or a tiger’s tooth, because post-wound inflammation is an early component of the healing process. But when that inflammation hangs on for too long, it impedes rather than speeds healing. Timing is everything.

In a study just published in Science Translational Medicine, Stanford researchers under the direction of perioperative specialist Martin Angst, MD, and immunology techno-wizard Garry Nolan, PhD, have identified an “immune signature” common to all 32 patients they monitored before and after those patients had hip-replacement surgery. This may permit reasonable predictions of individual patients’ recovery rates.

In my news release on this study, I wrote:

The Stanford team observed what Angst called “a very well-orchestrated, cell-type- and time-specific pattern of immune response to surgery.” The pattern consisted of a sequence of coordinated rises and falls in numbers of diverse immune-cell types, along with various changes in activity within each cell type.

While this post-surgical signature showed up in every single patient, the magnitude of the various increases and decreases in cell numbers and activity varied from one patient to the next. One particular factor – changes, at one hour versus 24 hours post-surgery, in the activation states of key interacting proteins inside a small set of “first-responder” immune cells – accounted for 40-60 percent of the variation in the timing of these patients’ recovery.

That robust correlation dwarfs those observed in earlier studies of the immune-system/recovery connection – probably because such previous studies have tended to look at, for example, levels of one or another substance or cell type in a blood sample. The new method lets scientists simultaneously score dozens of identifying surface features and goings-on inside cells, one cell at a time.

The Stanford group is now hoping to identify a pre-operation immune signature that predicts the rate of recovery, according to Brice Gaudilierre, MD, PhD, the study’s lead author. That would let physicians and patients know who’d benefit from boosting their immune strength beforehand (there do appear to be some ways to do that), or from pre-surgery interventions such as physical therapy.

This discovery isn’t going to remain relevant only to planned operations. A better understanding, at the cellular and molecular level, of how immune response drives recovery from wounds may also help emergency clinicians tweak a victim’s immune system after an accident or a saber-tooth tiger attack.

Previously: Targeting stimulation of specific brain cells boosts stroke recovery in mice, A closer look at Stanford study on women and pain and New device identifies immune cells at an unprecedented level of detail, inside and out
Photo by yoppy

Applied Biotechnology, Immunology, Infectious Disease, Research, Technology

Artificial spleen shown to filter dangerous pathogens from blood

Artificial spleen shown to filter dangerous pathogens from blood

79118_webOur spleens filter out toxins from our blood and help us fight infections. But serious infections can overpower our bodies’ ability to fight them off, especially among older adults whose immune systems are weaker. Now, a research team led by Donald Ingber, MD, PhD, of Harvard has come up with an artificial “biospleen” that can trap bacteria, fungi and viruses and remove them from circulating blood. Science Magazine describes the device in a news story:

The team first needed a way to capture nasties. They coated tiny magnetic beads with fragments of a protein called mannose-binding lectin (MBL). In our bodies, MBL helps fight pathogens by latching onto them. Ingber and colleagues showed that the sticky beads could grab a variety of microbes in the test tube.

With that key challenge out of the way, the researchers were ready to design the rest of the system. They engineered a microchiplike device a little bigger than a deck of cards that works somewhat like a dialysis machine. As blood enters the device, it receives a dose of the magnetic beads, which snatch up bacteria, and then fans out into 16 channels. As the blood flows across the device, a magnet pulls the beads—and any microbes or toxins stuck to them—out of the blood, depositing them in nearby channels containing saline.

The researchers first tested their device with donated human blood tainted with bacteria. They found that filtering the blood through the device five times could eliminate 90% of the microbes.

The device improved survival rates in rats and may decrease the incidence of sepsis, a dangerous side effect of severe infections. The researchers also found that the device could filter the total volume of blood in an adult human – about 5 liters or (1.3 gallons) – in about five hours.

Previously: Our aging immune systems are still in business, but increasingly thrown out of balance
Image, of the magnetic MBL-coated nanobeads beads capturing pathogens, from Harvard University Wyss Institute

Patient Care, Research, Technology

How can health-care providers better leverage social media to improve patient care?

How can health-care providers better leverage social media to improve patient care?

A growing number of Americans are turning to the Internet for health information and many are using social media tools to engage with patients like themselves or health-care providers. But findings recently published in the Journal of Medical Internet Research suggests that a significant portion of the health-related content on social networking sites is irrelevant or devoted to marketing or promotion of products, events and institutions. Study authors also warned that social media can quickly spread misinformation to a broad audience.

In the study, Stanford medical student Akhilesh Pathipati and colleagues analyzed Facebook search results for common medical conditions. Pathipati explains in a Sacramento Bee opinion piece how health-care providers can adopt social media strategies to address the  concerns mentioned above. He writes:

Providers should build online support systems that reach all patients. A PricewaterhouseCoopers poll found that 40 percent of respondents would use social media to cope with chronic medical conditions. If patients are embarrassed by having a stigmatized illness though, they may lack that coping mechanism.

In the short term, providers may want to set up private groups on social networking sites in which patients can interact with other affected individuals. Setting up an anonymous network may prove to be even more useful, as anonymity has been shown to help people share more about their health. The long-term goal should be to find ways to reduce the stigma associated with certain illnesses.

Previously: Lack of adoption of social media among health-policy researchers = missed opportunity, More reasons for doctors and researchers to take the social-media plunge and A reminder to young physicians that when it comes to social media, “it’s no longer about you”

Bioengineering, Research, Stanford News, Technology

Proteins from pond scum revolutionize neuroscience

Proteins from pond scum revolutionize neuroscience

pond scum smallI wrote a story recently about a cool technique called optogenetics, developed by bioengineering professor Karl Deisseroth, MD, PhD. He won the Keio Prize in Medicine, and I thought it might be interesting to talk with some other neuroscientists at Stanford to get their take on the importance of the technology. You know something is truly groundbreaking when each and every person you interview uses the word “revolutionary” to describe it.

Optogenetics is a technique that allows scientists to use light to turn particular nerves on or off. In the process, they’re learning new things about how the brain works and about diseases and mental health conditions like Parkinson’s disease, addiction and depression.

In describing the award, the Keio Prize committee wrote:

By making optogenetics a reality and leading this new field, Dr. Deisseroth has made enormous contributions towards the fundamental understanding of brain functions in health and disease.

One of the things I found most interesting when writing the story came from a piece Deisseroth wrote several years ago in Scientific American in which he stressed the importance of basic research. Optogenetics would not have been a reality without discoveries made in the lowly algae that makes up pond scum.

“The more directed and targeted research becomes, the more likely we are to slow our progress, and the more certain it is that the distant and untraveled realms, where truly disruptive ideas can arise, will be utterly cut off from our common scientific journey,” Deisseroth wrote.

Deisseroth told me that we need to be funding basic, curiosity-driven research along with efforts to make those discoveries relevant. He said that kind of translation is part of the value of  programs like Stanford Bio-X – an interdisciplinary institute founded in 1998 – which puts diverse faculty members side by side to enable that translation from basic science to medical discovery.

Previously: They said “Yes”: The attitude that defines Stanford Bio-X, New York Times profiles Stanford’s Karl Deisseroth and his work in optogenetics, An in-depth look at the career of Stanford’s Karl Deisseroth, “a major name in science”, Lightning strikes twice: Optogenetics pioneer Karl Deisseroth’s newest technique renders tissues transparent, yet structurally intact, The “rock star” work of Stanford’s Karl Deisseroth and Nature Methods names optogenetics its “Method of the Year
Photo by Tim Elliott, Shutterstock photos

Events, Medical Education, Medicine X, Patient Care, Stanford News, Technology

Stanford Medicine X: From an “annual meeting to a global movement”

Stanford Medicine X: From an "annual meeting to a global movement"

MedX_musical_finaleAs Medicine X came to a close Sunday, ePatient and American Idol participant Marvin Calderon Jr. gave a special vocal performance that moved audience members to their feet and ended in an explosion of colorful streamers falling from the top of the main auditorium at the School of Medicine’s Li Ka Shing Center for Learning and Knowledge.

The three-day event, which was attended by more than 650 people and watched via live webcast by several thousand more, is Stanford’s premier conference on emerging health-care technology and patient-centered medicine. The conference hashtag #MedX was a top-trending term on Twitter in the U.S. throughout the conference, with more than 48,000  tweets sent out between Thursday and Sunday.

Medicine X has historically examined how social media, mobile-health devices, and other technologies influence the doctor-patient relationship. But this year, the program also focused on how partnerships forged between health-care providers, patients and pharmaceutical industry would define the medical team of the future, amplify patients’ voices, and shape medical education. Along with the topics of relationships and connectedness, a number of key themes emerged over the course of the conference, including engagement, empathy, and the imp0rtance of  treating the whole person.

Daniel Siegel, MD, clinical professor of psychiatry at UCLA, touched on several of these themes during his opening talk about developing a healthy mind, an integrated brain, and empathetic relationships. “Our relationships give us a sense of being seen, of feeling felt, of feeling connected. Those are the fundamental ways we create well-being in our bodily lives,” he said. “We live in connection to each other… Relationship experiences that are stressful early in life can lead to medical problems later.”

Several sessions put a special spotlight on the importance of treating the whole person and the link between mental and physical health. Patients shared their experiences with depression and anxiety, and many revealed how they had to grieve the loss of their healthy self in order to accept their new life. They also spoke about how they felt weakened by their mental-health condition and struggled to be empowered, or proactive, in their health care. Gonzalo Bacigalupe, EdD, MPH, a psychologist and professor of counseling and school psychology at the University of Massachusetts Boston, told patients, “Maybe the ‘e’ in ePatient is not enough. Maybe you need a ‘c’ that stands for connected. If you are connected, then the burden that you are feeling can be shared.”

Larry Chu and patient - smallSentiments about the need to foster empathy in medicine were discussed in parallel panels and during coffee break chats. Emily Bradley, an ePatient with a rare type of autoimmune arthritis, told attendees at a session about invisible pain, “I don’t fault my loved ones for not understanding my pain. I don’t want them to understand and I’m glad that they don’t. I think what’s missing is empathy.” Liza Bernstein, an ePatient advisor and three-time cancer survivor, told attendees at the closing ceremony, “Empathy doesn’t need that much. All empathy needs is us.”

The conference also tried to keep a focus on all different types of patient populations – including those who underserved. “There is a disconnect between solutions being build and the needs of vulnerable populations,” said Veenu Aulakh, executive director of the Center for Care Innovation during a talk on the “no smart-phone” patient. “We need to be designing [solutions] for today, not the future, and the 91 percent of patients that have a text-enabled phone.”

Larry Chu, MD, executive director of the conference (pictured above with Bernstein), warmly greeted the audience each morning – and on Saturday had a special announcement:  the launch of Medicine X Academy, a new effort aimed at continuing to build community among all stakeholders in health care and filling important gaps in medical education. The initiative will include a second conference in 2015 titled Stanford Medicine X ED (currently scheduled for Sept. 23-24, 2015). Joining Chu on stage to talk about the initiative, Bryan Vartabedian, MD, a Baylor College of Medicine physician and a longtime speaker at the conference, told attendees that medical education is “ripe for disruption.” And he noted that Medicine X – which has evolved “from an annual meeting into a global movement,” was poised to take it on.

Speaking of a global movement, there was very much a sense during the weekend that what was happening was bigger than just a conference – with at least one panel moderator telling attendees, “This conversation doesn’t end when we leave the stage.” And Bernstein summed up the three days of panels, presentations and powerful Ignite talks from ePatients saying, “I leave here re-energized, recharged, re-inspired and I hope you do too. Stay in touch on Twitter and see you next year!”

More news about Stanford Medicine X is available in the Medicine X category.

Previously: Medicine X explores the relationship between mental and physical health: “I don’t usually talk about this”, At Medicine X, four innovators talk teaching digital literacy and professionalism in medical school, What makes a good doctor – and can data help us find one?, Medicine X aims to “fill the gaps” in medical education, Stanford Medicine X 2014 kicks off today and Medicine X spotlights mental health, medical team of the future and the “no-smartphone” patient
Photos by Stanford Medicine X

Medical Education, Medical Schools, Medicine X, Technology

At Medicine X, four innovators talk teaching digital literacy and professionalism in medical school

At Medicine X, four innovators talk teaching digital literacy and professionalism in medical school

med ed panelOne of my favorite talks yesterday at Stanford’s Medicine X was “Fostering Digital Citizenship in Medical School,” where four esteemed panelists talked about the innovative programs they’ve put in place at their institutions.

The physicians joked several times that a good panel often involves controversy or conflict among speakers – but the four of them weren’t in disagreement about much. They all believe that things like understanding social media and knowing how to build one’s digital footprint are crucial skills for doctors-to-be, even if those aren’t an obvious focus for the students themselves. “We can’t expect students to understand” this, said Warren Wiechmann, MD, an associate dean at UC Irvine School of Medicine. “They’re focused on learning core forms of medicine.” (Wiechmann started in 2010 a program to provide each incoming medical student with an iPad and has since added to the school’s curriculum courses on topics such as social media, wearables, and new digital trends in medicine.)

Kyra Bobinet, MD, PhD, who worked alongside Stanford anesthesiologist (and Medicine X executive director) Larry Chu, MD, to develop and teach Engage and Empower Me, an online course that focuses on patient-engagement design, noted that it’s academic leaders’ job to be “forward-thinking” for the students “so they’re so they’re not behind” when they become physicians. And Bryan Vartabedian, MD, who created at Baylor College of Medicine Digital Smarts, a four-year curriculum that focuses on “professionalism, safety, and mindfulness with social media,” agreed. “We’re asking big questions here,” he told the audience. “What does a doctor need to know 20 years from now? Will he (or she) know how to send a tweet? Do we have to be platform-specific [when teaching]?”

A portion of the 45-minute talk was devoted to the difficulty of incorporating new things in a medical school’s curriculum, which is, panelist Amin Azzam, MD, said, already “chock full.” Said Wiechmann: “The big dilemma is what do we take out to put in in?” In turn, many of the schools’ instructions on digital professionalism and literacy come in the form of elective courses.

When discussing other challenges, Wiechmann said the “line ups not very deep” when it comes to leaders in medical school who know about digital media. These topics aren’t “even on the radar” of many faculty-instructors, he said. The panelists also mentioned that the students – most of whom barely remember a time before e-mail, and many of whom consider themselves tech-savvy – don’t always think they need training on digital issues. “In one way they know a lot about technology, but they don’t get how to be doctors,” pointed out Azzam, who developed a University of California elective course that allows 4th year medical students to edit Wikipedia for academic credit. (“We want them to be digital contributors, not merely digital consumers,” he explained.)

Vartabedian said the information that Baylor provides to their students is contextual. Teaching medical students about smartphone use or social media in general wouldn’t be terribly helpful, he pointed out – but it becomes valuable “if you talk about it in the wards.” What should you do, for example, if a patient engages you via Twitter?

The end of the discussion shifted to patient engagement and the need to educate students about just the thing Vartabedian mentioned (i.e. how to interact with patients on social media) and how the e-patient movement works. “I have a responsibility as an educator to put this content [about patient engagement] – more than, say, biochemistry – in front of students,” said Wiechmann.

More news about Stanford Medicine X is available in the Medicine X category.

Previously: Medicine X aims to “fill the gaps” in medical education, More reasons for doctors and researchers to take the social-media plunge, A reminder to young physicians that when it comes to social media, “it’s no longer about you”, A conversation about digital literacy in medical education, Advice for physicians when interacting with patients online and How can physicians manage their online persona? KevinMD offers guidance
Photo by Stanford Medicine X

Medicine and Society, Medicine X, Patient Care, Technology

What makes a good doctor – and can data help us find one?

What makes a good doctor - and can data help us find one?

Ornstein panelWhile much conversation at Medicine X focused around the doctor-patient relationship, ProPublica reporter Charles Ornstein posed to conference attendees this morning a more fundamental question: How do you find a doctor? “This is trickier than you think,” he said and proceeded to discuss how data can yield helpful information for those looking for (or assessing their current) physician. He outlined some of the information – mostly involving doctor-industry relationships and physician-prescribing practices – that ProPublica has gleaned from federal databases, and he outlined questions that patients might want to ask their doctors about such things. (“So my doctor has a relationship with a company. But how is that affecting my care?” he said.)

Ornstein spent a good amount of time discussing the importance of making information – presumably not just information on negative things, such as whether a doctor appears to over-prescribe a certain medication or has ever been disciplined, but also about thoughts on physicians’ care from patients – more widely available.“We all want doctors who are good at what they’re doing clinically, and it’s time for us to stop making that a secret,” he said, before making his closing statement that “Data should be freed so we can make better health-care decisions.”

In the panel session – moderated by our own Paul Costello – that followed, several important points were made. First, Vivian Lee, MD, PhD, MBA, dean of the University of Utah School of Medicine and CEO of University of Utah Health Care, reminded the audience that the “majority of doctors are not bad apples” and can improve on things if given the chance. University of Utah makes patient-survey information publicly available, and she described the six-month period before this service was launched as a time where doctors worked to boost their level of care. Almost every doctor received at least 4 out of 5 stars by the time the rankings went online, she said.

Panelist Carly Medosch, a patient advocate who has had Crohn’s disease for 20 years, expressed support for access to physician data but pointed out that she doesn’t have time to dig through “tons and tons of research” – she not only has a regular job but a second job managing her disease. And “If I’m taken to the ER for a ruptured intestine I don’t have time to ask questions” about, for example, a doctor’s industry relationships, she pointed out. It was an important reminder that access to data alone might not greatly benefit the average chronically ill patient.

Towards the end of the session, the panelists shared their own ideas of what makes a good doctor, with Ornstein listing good clinical outcomes and empathy as two must-haves. Numerous attendees took to Twitter to express their own thoughts, including patient advocate Liza Bernstein, who offered at least 10 criteria. (My personal favorite: “What kind of PERSON are you? Yes, always, top of your field, but are you a #mensch?) Given the complexity of the issue, as outlined during the panel, I think this attendee hit the nail on the head by tweeting:

What makes a good doctor? Medicine is not a monolith. There is no simple, single answer, regardless of data availability.

More news about Stanford Medicine X is available in the Medicine X category.

Previously: Medicine X aims to “fill the gaps” in medical education, Relationships the theme of the day at Stanford’s Medicine X, Stanford Medicine X 2014 kicks off today and Medicine X spotlights mental health, medical team of the future and the “no-smartphone” patient
Photo of Ornstein (far right) and panelists by Stanford Medicine X

Stanford Medicine Resources: