Categories
Global Health Innovation Technology

How Remote Work Is Changing Medical Practice in the Era of Coronavirus

Societies across the world have been disrupted by the Covid-19 pandemic, with millions of people being forced to stay indoors and many losing their jobs. But this very disruption has ushered us into what could be the new future of work. Remote work itself has been around for years but, traditionally, companies prefer their employees to work at their physical headquarters. That’s all beginning to change as a result of the pandemic.

With no choice for companies, entire industries and employees alike were forced to embrace remote work—yet this may just be the beginning. In fact, Business Insider recently discussed 12 different companies that were extending remote work, with some end dates as far away as the summer of 2021.

For other industries, however, there may not even be a return to the office on the horizon. 

Technology has made remote work possible but, ironically, has also been a disruptive force that has uprooted traditional jobs. This trend has only been accelerated by remote work—employers have realized just how many jobs can be done from the comfort of their homes. 

Over the past few years, the medical field has been slowly merging with technology. Every aspect of the healthcare system, from entire hospitals to physicians, is being influenced by new technological trends, including remote work. The future of the field has never been more unclear.

Flexibility with Administrative Tasks and Employees

In the coronavirus era, medical professionals are in high demand for obvious reasons. Many medical facilities have transitioned to working remotely. In fact, the automation of administrative tasks has been a major byproduct of the Covid-19 pandemic.

Offices around the country report feeling positive overall about these changes. Medical Economics recently examined Lugo Surgical Group, based out of Texas, who have been operating remotely for two years, showing that this is viable.

Each week, the owner of this clinic, Rafael Lugo, reserves a day and a half to meet with patients. Every other aspect of the surgical process—including billing, scheduling, and follow-ups—are done remotely. 

While doctors and nurses still need to meet with patients in person, it is clear that this is not the case for administration. This new hybrid business model has altered the jobs available in the medical field. In fact, the Bureau of Labor Statistics projects a 9% decline in secretarial or administrative assistant jobs over the next decade. Nonetheless, Covid-19 has highlighted the need for in-person physicians but has demonstrated that administrative workers are not essential for the office.

The Emergence of Artificial Intelligence Systems

While admin roles may be on an accelerated decline due to Covid-19, their replacement is coming far quicker. Artificial intelligence systems are impacting every field of business and its impact on medical practices is profound. Handling administrative tasks is just the tip of the iceberg for these advanced systems; however, there is a downfall. The trust medical offices have placed on these systems during the pandemic may result in them relying on AI to handle more intricate jobs.

As such, AI is changing medical practices, particularly when it comes to patient care. Surgeries powered by robotic instruments that are controlled by a surgeon are becoming extremely popular, and some systems are now able to diagnose patients quickly based on information inputted in the system. As these systems continue to develop, new jobs will open in the field of medicine based on regulating this technology and developing it.

Entire companies may form, focused on developing and then producing these AI and robotic systems. DaVinci Systems is a modern example, as the company produces surgical robots that are controlled via a human surgeon at a desk. These devices have already been approved for urological procedures, radical tonsillectomy, and even tongue base resections. Remote work has shown a new way in which these systems can be helpful. In truth, this pandemic could very well result in a future where there isn’t even a human surgeon behind the robot.   

Altering Career Paths and Customer Expectations

Before the pandemic, a common headache for patients was the annoying wait times and variability in the quality of service provided by the doctor. During the pandemic, though, wait times have become non-existent, with medical professionals able to conduct their job over a Zoom call. Additionally, the advancements of artificial intelligence systems could result in more accurate diagnosing in the future. Having access to medical professionals wherever and whenever, however, may have its drawbacks—patients may become disgruntled if medical practices return to normal after the pandemic settles.

As for doctors and other medical practitioners themselves, Covid-19 isn’t just changing the way they work, but also how they progress in their career. Online nursing programs, offered by accredited schools such as Johns Hopkins University and Rutgers University, have become more popular during this pandemic. With the number of people earning their degrees online increasing, remote learning practices may ease the transition to remote work. This could also contribute to the industry-wide switch over to automation powered by artificial intelligence.

Covid-19 has changed the way entire industries operate and the medical field is no exception. From artificial intelligence replacing administrative jobs to the way budding practitioners are learning the ropes, reliance on technology has increased as a byproduct of the pandemic. This is likely to lead to a future where medical practices are largely automated and in-person visits to the doctor are disrupted by robotics. 

Based on current trends, these changes were inevitable, but the pandemic may have accelerated them. While the future of the coronavirus is unclear, its effects on the workforce and jobs may be permanent—the way work is handled could be disrupted forever.

Categories
Community Service Emotion Empathy Global Health Healthcare Disparities Innovation Medical Humanities Patient-Centered Care Public Health Reflection

Beyond Medicine: The Peer Med Podcast, Serving Humanity !

Doctors are men who prescribe medicines of which they know little, to cure diseases of which they know less, in human beings of whom they know nothing.” – Voltaire

The covid-19 pandemic has claimed millions of lives, shut down economies, restricted movement and stretched our healthcare systems to the edge; but despite this time of destruction, Peer Med, a podcast dedicated to serving humanity was born! Established as a platform for creation, innovation and above all a platform for unity.

A student-led initiative of the Peer Medical Foundation, the Peer Med podcast intertwines medicine, an ever changing science of diagnosis and treatment, with conversations about issues in healthcare where lives are on the line. Due to the fashionable focus of medical education on biology, pathology and disease there has been a reduced emphasis on the social determinants of health. As such physicians lack an empathetic character understanding the human aspect of medicine and in this, fail to communicate effectively rendering patients dissatisfied with care.

Seeing the need for more fruitful discussions, the Peer Med Podcast provides listeners with a more nuanced interpretation encouraging health professionals to look beyond medicine and into the experiences, values and beliefs of patients to assure a successful therapeutic relationship. It serves as a reminder of the importance of self-determination, beneficence, non-maleficence and justice as medicine naturally exposes health professionals to the darker side of human existence. The podcast explores these themes by delving into the underbelly of life where homelessness, drug addiction, abuse, trauma, and death are brought to the surface of conversations. It takes the already prevalent cases of strokes, pneumonia, heart attacks, fractures, and miscarriages from the everyday scenarios in emergency rooms plaguing our species and encourages a more humane outlook amidst all conflict and chaos.

“Doctors are men who prescribe medicines of which they know little, to cure diseases of which they know less, in human beings of whom they know nothing.”

– Voltaire

Founded on March 24th at the start of the COVID-19 pandemic, Peer Med is dedicated to humanity and the millions of people worldwide without access to education, health and water, sanitation and hygiene (WASH) services. The podcast aims to inspire, engage and promote action to solve challenges in global health, human rights and medicine. Acknowledging that the delivery of healthcare requires a team effort, the podcast invites everyone from clinicians, advocates, economists and even comedians to delve into the subjects of medicine. While peer-reviewed information is important, not all valuable work belongs in an academic journal. In order to strengthen health systems a multidisciplinary set of perspectives is required to teach and inspire people. Therefore, Peer Med encourages dialogue so that all listeners may raise their voices advocating for humanity.

Ensuring Peer Med is truly a global podcast is the goal but despite the best intentions to ensure inclusivity, barriers in terms of gender, language, and access prevent this from happening. To tackle the problem, Peer Med aspires to invite speakers from all corners of the world, not only to assure equitable representation but to also gain advice on how to empower those in low-and-middle-income-countries (LMIC) so that their voices may be heard. In serving humanity, Peer Med is completely free and available on a variety of platforms aiming to leave listeners refreshed, empowered and motivated to effect change. These can be heard from a mobile phone, shared via social media, or played for a friend. The conversations will leave listeners burning with a flame in their hearts to do their utmost on life’s quest to serve humanity.

It serves as a reminder of the importance of self-determination, beneficence, non-maleficence and justice as medicine naturally exposes health professionals to the darker side of human existence. The podcast explores these themes by delving into the underbelly of life where homelessness, drug addiction, abuse, trauma, and death are brought to the surface of conversations. It takes the already prevalent cases of strokes, pneumonia, heart attacks, fractures, and miscarriages from the everyday scenarios in emergency rooms plaguing our species and encourages a more humane outlook amidst all conflict and chaos.

Leah Sarah Peer

The support for the podcast has been humbling as love has poured in from around the globe. So many are keen on sharing their stories and this speaks volumes to the passion of the podcasts’ guests, their enthusiasm and commitment to mankind. Some have included a world renowned speaker and human rights champion, a Brooklyn-based singer, songwriter, teacher and PhD candidate in Comparative Literature, a range of student initiatives – Meet the Need Montreal, Helping Hands, to Non-profit Organizations such as Med Supply Drive and so many more.

World-Renowned Humanitarian & Neuroscientist, Abhijit Naskar

If there is something the COVID-19 pandemic has taught us, it’s the power of community and compassionate care’s strength in uniting us across the world. Peer Med hopes to serve as a medium for inspiration, for reflection, and invites people from across the healthcare spectrum to come together committed and dedicated to serve humanity.

To listen to Peer Med, visit Spotify, Apple Podcasts. To read about the individual episodes visit the website for more.

Categories
Empathy General Medical Humanities Opinion Reflection

Visual Arts as a Window to Diagnosis and Care

With the rapid advancement of knowledge and technology in medicine, physicians alienate themselves from the core purpose of their profession. A grounding in the humanities as well as a strong foundational basis understanding the medical sciences is required to establish well-rounded physicians. Art inspires medical students and physicians to observe detail they otherwise wouldn’t. With patients in the emergency room, before any physician-patient interaction can occur, the sounds of bilateral crackles, the sight of neck muscles contracting and of the nostrils flaring indicate a patient in respiratory distress. This very detail in observation is needed for split-second decisions of utmost importance in the emergency theatre.

Art is the projection of our experiences, memories and has the power to record reality and fantasy. These altogether add to the artistic memory of an artist and allow them to add adaptations based on their life’s observations. Artists have captured the human body through the pursuit of conveying human experience, of the human’s appearances, shapes, and sounds all reflecting their state of health. Artists must see the details of a picture and reproduce it, and only once they’ve mastered observational art can they move on to more abstract forms conveying emotions of the real world.

When dissections were forbidden centuries ago, artists together with doctors snuck out to examine human corpses for a closer look. This was important for them to accurately reproduce representations as they not only had to know the inner workings of the human body just as physicians did but they needed the eye for their artistic creation. Unfortunately, today the acquisition of life-drawing skills has lost its traditional importance due to increased demands for the more conceptual art forms.

In medicine, observational skills provide insight into a patient’s problem.  From observing, not only do we see it as is but we recognize patterns, are able to analyze context and make connections. Despite knowing everything about a disease or illness, learning how to see pathologies, and diagnostic criteria is important to avoid missing all the signs. The four steps of physical examination are inspection, percussion, auscultation and palpation. Inspection or observation is often overlooked but is so crucial to patient care and treatment as is to the creation of art.

The artwork of Piero di Cosimo, A Satyr Mourning over a Nymph (1495) depicts a young woman killed accidentally during a deer hunt by a spear. Upon analysis of the painting and deep observation, evident is that there is no spear wound but instead the women’s arms are covered with long cuts as if acting in self defense from her assailant. Her left hand additionally is placed in position with her wrist flexed and fingers curling inwards known as “waiter’s tip”. Fundamentally at large, di Cosimo used the girl’s corpse as a model and because as an artist he had no understanding of medicine and injury, he portrayed exactly what he saw. Unintentionally, he captured the girl’s true injuries dictating to a medical practitioner the likely theory of the young woman’s actual cause of death.

A Satyr mourning over a Nymph by Piero di Cosimo
https://www.nationalgallery.org.uk/paintings/piero-di-cosimo-a-satyr-mourning-over-a-nymph

Appreciation for paintings by physicians even reveal medical diagnoses given the structural facial characteristic changes that occur in different diseases. The Old Woman by Quinten Massys depicted an exaggerated ugliness due to the pattern of facial deformations; bossing forehead, prominent cheekbones, enlarged maxilla and increased distance between the mouth and nose all consistent with leonine faces of Paget’s disease stemming from accelerated bone remodeling. Another example is that of Peter Paul Rubens, The Three Graces, displaying symptoms of benign hyper-mobility syndrome, an autosomal dominant disease. Scoliosis of the spine, a positive Trendelenburg sign and double jointedness as well as lax upper eyelids is evident in the artists painting.

Fascinating nonetheless is that the medical diagnoses in both paintings were unknown to doctors at that time. Paget’s Disease and benign hyper-mobility syndrome were discovered just a couple years ago while these paintings existed long before them. 

Compared to artists however, doctors have stopped putting their skill of inspection into practice and with all the expensive tests available to help doctors make diagnoses, the necessity of individual, physician observation has decreased. Thus raises a question, will the dependence on tests rather than investigation through the senses define the future of medicine?

As medical students, this urges us to hold true to the art of observation. Technological advances were directed to improve patient care and not impede the physician-patient relationship. The personal touch of a doctor and the direct communication through movement, and language has been lost. Remembering the feelings of our patients allows us as future physicians to be mindful that no patient manifests the same way despite presenting with the same disease. Neither are patients aware of the manifestations of disease and overtime naturally adapt to the abnormal posture, gait, and lifestyle changes often overlooking the skin changes, mood or weight fluctuations.

When doctors are trained to “see”, observe and infer from signs alone a basic diagnosis, will they understand the whole human being. Therefore, arts education in medicine helps humanize science and connect medical theory into the patient’s journey. In analyzing art pieces, students are able to connect clinical skills and improve their ability to reason with the physiology and pathophysiology of the human body from visual clues alone causing them to become more emotionally attuned to their patients and aware of their own biases as physicians.

The skills of observation requires improvement and practice from physicians to both diagnose and understand the underlying concerns of a patient. Only when doctors have mastered the art of observation and trained their eyes to truly see, will they ultimately return to a world of greater human connection in medical practice.

References
McKie R. The fine art of medical diagnosis. The Observer. 2011 September 11;Culture. 
Berger L. By Observing Art, Med Students Learn Art of Observation. NY Times. 2001 January 2;Health
Christopher Cook. A Grotesque Old Woman. BMJ 2009;339:b2940
Dequeker J. Benign familial hypermobility syndrome and Trendelenburg sign in a painting “The Three Graces” by Peter Paul Rubens (1577–1640). Annals of the Rheumatic Diseases 2001 September 01;60(9):894-­‐895.
Pecoskie T. Improving patient care with art. The Spec. 2010 December 2;Local. https://www.mcgill.ca/library/files/library/susan_ge_art__medicine.pdf

Categories
Interview Lifestyle

Residency Interview Tips for a Virtual Cycle!

Virtual interviews are in full swing for medical school, residency, and fellowship applicants. Here are some tips to make the most of your interviews. Wishing you all the best!

Making a good virtual impression:

In the virtual format, your first impression is not your firm handshake or tailored suit. It will be the quality of your internet, audio, and video! Make sure you are well prepared to stand out. Here are some supplies you may consider for Zoom interviews. Although these are just suggestions, we recognize that many individuals face financial barriers that may limit access to technology:

  1. Audio: Headphones with a microphone (prevents reverb from your computer audio), consider noise reducing microphones to block out any background noise.
  2. Lighting: A bright lamp or ring light placed in front of you so your face is well lit. May consider having it higher than eye level so you are not squinting and looking directly into the bright light.
  3. Video: Webcam with 1080p quality (can consider buying an external webcam which will have much better quality than a laptop webcam).
  4. Reliable internet 
    1. You may check your internet speed by typing “internet speed test” into Google. 
    2. Consider a wifi extender if you must be far away from your main router. It will expand the reach of your internet to parts of the building that may not get good service, and prevents lag for a seamless interview.
    3. Have a backup internet and computer option if things go wrong– can use your phone’s mobile hotspot in case you lose your main wifi connection. Borrowing or using a backup ipad, laptop, or desktop computer can also be helpful if your computer breaks down suddenly.
  5. Background: 
    1. A chair that does NOT swivel (so it’s not distracting).
    2. Put your setup against a white or neutral background (can use removable wallpaper or a blanket if you don’t have this available). 
    3. May also consider an interesting and professional background item like a bookshelf, fun painting, plants, or your favorite photos can make for a great conversation starter and highlight your hobbies! 
    4. If you have your bedroom as a background, make sure it is clean and spotless.
      1. Tape something by your camera to remind you to make eye contact with the camera while speaking.
      2. Download and test the interview platform beforehand (Zoom, WebEx, etc).

Answering Questions: 

Prepare a GREAT answer to each of the following questions:

  1. Tell me about yourself
  2. Why this specialty
  3. Why this school
  4. Strengths and weaknesses
  5. Interesting/challenging patient case
  6. Behavioral: 
    1. Time you failed
    2. a mistake you made
    3. working on teams, being a leader
    4. dealing with a conflict
  7. What do you do for fun?
  8. A short spiel about EVERY activity on your application, what you did, and what you learned from it. 
  9. Be able to talk intelligently about any research including your role, the hypothesis, analyses, results, and conclusion.
  10. Any questions for me?

Staying organized for interview invites!

You will be getting a LOT of emails. 

  1. Make a calendar where you are writing down dates of all interview invites as you schedule them so you can quickly glance if you get a new invitation and so you don’t double book yourself. Can sync your calendars across different platforms (ie Outlook to Gmail/google to iOS).
  2. Have a separate email account just for your interviews that will spam you with notifications so you are very unlikely to miss anything.
  3. Be professional and cordial in all emails that you send to the program coordinator, residents, etc.
  4. Here are all the ways you can get a notification about an interview invite:
    1. Text messages (set up forwarding in gmail to your phone number)
    2. Email notifications (enable notifications on your phone)
    3. Email forwarding to your main/school account
    4. Desktop notifications
  5. Here are the major platforms for scheduling interview invites
    1. Thalamus
    2. ERAS (noreply@aamc.org)
    3. Interview Broker
    4. Direct emails from the program coordinator

Best of luck!