Sunday, January 31, 2010

Doctors, The Internet, And Social Media

As you know, or can probably figure out, I have an interest (or even a passion for) medicine and technology. So, I very much have an interest to see how technology can help me in my job. I have particular interest in seeing how social media (blogs, podcasts, facebook, twitter, etc) can help me communicate the message better.

This past week, Dr. Kevin Pho, better known as KevinMD, had an op-ed piece in USA Today online entitled "Doctors Ignore Internet At Their Own Peril." It's no secret that Kevin has used social media and the internet to help get the message out on the unique physician view on medical and health policy issues. In his own Linked In profile, Kevin describes himself as "Social media's leading physician voice," and I very much agree with that. In the USA Today piece he says this:
Doctors who are not active online risk being marginalized. Facebook and Twitter users, half of whom are under of age of 34, rely on the web for most of their information. As this demographic ages, it’s conceivable that they will consult social media first to answer their health questions.
Below, you'll see two TV interviews I did on December 18, 2009, on local TV news, talking about Doctors and the Internet (link to interview1 and interview 2).

Almost every day, I have patients ask me about information that they read online or heard from a friend which then directed the patient to search online for more information. I agree with Kevin that docs that continue to marginalize online information or marginalize social media - will themselves be marginalized. (If you would like to see more of my interviews from local TV news on a variety of topics, check out MikeSevilla.TV)

Saturday, January 30, 2010

Facebook/Twitter Break? FAIL!

Two weeks ago, I set a goal for myself. I told myself that I would "unplug" from both Twitter and Facebook for two weeks. Initially, that meant not even logging into each of the sites and checking what was going on. Well, I'm proud to say that lasted a mere four days. FAIL!

After I logged in (four days later), I then told myself that on Facebook, I would not leave any comments or do any of that "thumbs up" thing that is so easy to do. Well, that lasted another two days. FAIL! I mean, hey, it is so easy to hit the "like" button when you see something funny or just agree with something you see. And, I couldn't help, but comment on a thing or two on FB.

Finally, I told myself that I would not leave a status update or tweet for the remainder of the two week period. Well, during and after the iPad announcement, I just couldn't hold back any more. I wrote a blog post, and I couldn't help but just post up a link on twitter telling people about it. Oh well.

Even though, I say "fail," I don't think that it was (really). I also told myself that I wanted to start blogging (in a long format as opposed to microblogging) again. And I think that I have found the "blogging bug" again - which is a good thing. I have a handful of posts here in "draft" mode and I hope to get back to them to finish.

In addition, my brief "unplugging" experiment told me that I used the computer as an easy excuse for not getting out there and hanging out with real people - in person - here - where I live. I was always thinking of what the next tweet or facebook update would be.

As I jump back into the sea of facebook and twitter after a semi-sucessful mission, one of the things I've definitely decided upon is that I will not be updating as much as I have in the past (really). I apologize if anyone thought I had abandoned these platforms. I was just taking a little break. Now, I'm back. But, I won't be tweeting or updating as much as before. And, that's a good thing, I think.....

Thursday, January 28, 2010

iPad For Medicine Is About The Software

In kind of browsing around today, it seems that almost every industry - including education, aviation, business, and medicine - is excited about the latest Apple piece of hardware called the iPad. It's so entertaining reading the apple haters and those in the tech industry complain about the iPad - sheesh!

Anyway, focusing back on the medicine and health care industry, there have been a number of posts that I have read talking about the potential of the Apple iPad device. On KevinMD, Steve Woodruff has a good piece touting the awesome hardware potential of the device and the ideal end point of its use in the medical setting.

A heavily referenced article is from Venture Beat called "Apple tablet reps spotted at LA hospital" which talks about how Apple reps were there "three or four times" in the weeks leading up to the iPad launch. Rumors included that hospital execs and even some docs got to see previews of this piece of hardware.

In an article from TinyComb, they make reference to Motion Computing and their mobile model called the "C5." The C5 is 3-pounds (iPad is 1.5 pounds) and has a price tag of $2199 (iPad base price is $499). We use the C5 device in our hospital. So, I'm familiar with it's pluses and minuses for uses in the clinical setting.

In my view, all of this early analysis misses the point. As a hardware device, I would love to use this in my job right now in the hospital and in the office. I would love to let go of my netbook at the office and use the iPad. I would love to make my hospital rounds with the touch screen and get everything done using this cool form factor.

But, it's not about the hardware people. It's all about the software. Will the corporate EMR hospital and office vendors write updates and patches for iPad? I really doubt that (at this point). I mean they are busy as it is with their own interoperability issues as well as big picture issues like keeping up with CCHIT certification and the mysterious term called "Meaningful Use" which helps hospitals and doctors obtain federal stimulus monies for "meaningful use" of EMRs.

I can just see EMR vendors saying now, "Oh yeah, we can write software to use iPad on the hospital system. It will be an additional (several) hundred thousand dollar price tag for that feature. And, we agree. It'll be cool to see iPads using our system..."

Don't get me wrong, I'm as excited about iPad as the people in the articles above. But, don't expect iPad's impact for medicine to be anytime soon, or to come at a cheap price for hospitals or doctor's offices.....

Update: Greeting to those of you who clicked over from The Blog that Ate Manhattan, Health Highlights, Grand Rounds v6.19, MobiHealthNews, or Wall Street Journal link. I invite you to check out other posts over here. Thanks for stopping by!

Tuesday, January 26, 2010

Apple Tablet?

I don't know about you, but I'm more interested in what Steve is going to say tomorrow verses the State of the Union address from Washington. What many people fear (me included) is the possibility that instead of the awesomeness of an iPhone type announcement - what we'll get instead is along the lines of the "mac cube" which flopped a year after it was triumphantly brought out by Steve. We'll see what happens tomorrow....

Monday, January 25, 2010

2009 Medgadget Weblog Award Finalists

Yes kids, it's that time of year again when we vote for our favorite medical weblogs for the previous year. This is of course from our friends at Medgadget. And, you can take a look at all the finalists here. In 2008, I had the honor of having Dr. Nick Genes on Doctor Anonymous Show number 19 to talk all about the Medgadget Medblog Awards. You can listen on the player below. Or, you can download the show here and listen anytime.

Later that month in Jan 2008, Nick returned to the show with the other Medgadget guys to make a final push for voting that year. I believe even Mr. Paul Levy himself called into the show trying to get himself some votes. Listen in the player below or download Dr. A Show 21 right here.

Now, the category that is near and dear to my heart is the Best New Medical Weblog category. Back in the day (hehe) when I was a better blogger than I am now, I begged to be nominated for the best new blog award, and I begged to be voted for - way back in 2007. Who won that category that year? Interestingly enough it was the notorious Dr. Flea.

Anyway, I normally don't do endorsements. I mean, not that anything I say would influence anyone to vote one way or the other. I did want to point out one blog in the New Medblog category called StorytellERdoc.

I have to tell you, if you haven't checked out this blog - you have to. It's a great read. And, for what it's worth, I encourage you to vote for this blog in this category. Best of luck to all the nominated blogs across all the categories this year. And, please show some love and cast your vote to whomever you think is the best in each of the categories...

Friday, January 22, 2010

Quit Smoking & Survive Lung Cancer

Yes, you read that title right. Intuitively, it makes sense. Quit smoking and you can decrease your chance of lung cancer. But, now, there is data out there that patients with early lung cancer - who quit smoking - not only increase their rate of survival - they can double their chances of survival. The article talking about they study is from the Associated Press entitled, "Smokers With Cancer Could Quit And Double Survival."
People with lung cancer who continued smoking had a 29 to 33 percent chance of surviving five years. But those who kicked the habit had a 63 to 70 percent chance of being alive after five years. The research was published Friday in the BMJ, formerly known as the British Medical Journal. Lung cancer is the top cancer worldwide, and the prognosis is usually poor. Only about 7 percent of patients make it to five years, though about 20 percent of patients are diagnosed early enough to be treated.

"The message is you should never give up on giving up (smoking)," said Amanda Parsons, of the U.K. Centre for Tobacco Control Studies at the University of Birmingham, who led the study. "Even at the stage where you have been diagnosed with early stage lung cancer ... if you give up smoking, your body can still partially recover and your risk is reduced," she said.
I once thought (and a lot of patients thought) that when you are diagnosed with lung cancer - it doesn't matter if you quit smoking or not. I fully admit that I have never smoked, ever. I don't personally know how difficult it is to quit. But, I have a lot of patients, who I talk with every day, and, they tell me the struggles that they go through when they try to quit again, and again, and again. At least I can tell them that even if you are diagnosed with early lung cancer, there is data out there saying that it is still not too late to quit smoking....

Thursday, January 21, 2010

Warning: Sitting Can Kill You

You think I'm kidding about this, dont you? Well I'm not (hehe). There was a study just published this week which says exactly this. I got the story from the Associated Press in their article entitied, "Experts: Sitting Too Much Could Be Deadly."
Research is preliminary, but several studies suggest people who spend most of their days sitting are more likely to be fat, have a heart attack or even die. In an editorial published this week in the British Journal of Sports Medicine, Elin Ekblom-Bak of the Swedish School of Sport and Health Sciences suggested that authorities rethink how they define physical activity to highlight the dangers of sitting.
"After four hours of sitting, the body starts to send harmful signals," Ekblom-Bak said. She explained that genes regulating the amount of glucose and fat in the body start to shut down. Even for people who exercise, spending long stretches of time sitting at a desk is still harmful.
So, right after reading this blog post (and telling your friends about it - hehe), get up people and move around. Exercise those muscles! Maybe that great REM song (see below) was right - "Stand in the place where you live...."


Wednesday, January 20, 2010


The death of a young person is always a tragedy. Recently in this little town, there was the death of a young person in her/his 20s of a chronic medical condition. It really doesn't matter what the cause is. But, for the sake of this story that was the cause.

One of the great things about primary care is at the same time one of the most painful things about primary care - namely the relationships that docs like me experience. I know I haven't done a good job of "disguising" things or "de-identifying" things from a personal standpoint. You could probably infer from my writing that this person was connected in some way with the office.

Sometimes there are incidents in life which really make you think of what is important in life. It's not really what's going in in other parts of the country, or other parts of the world. What matters is what is happening right here - things that will definitely not make the evening news, yet will impact me in ways that I don't even know about yet.

Life in a small town as a primary care doc gives me experiences - both good and bad - I would not get anywhere else in the world. Where am I going with this rambling post that doesn't make sense? Who knows? Maybe for the first time in a long time I'm really thinking of my mortality? Maybe I'm angry that, yes, sometimes bad things happen to the nicest people. Maybe it just comes down to asking myself - What is really important to me in my life right now? Hmmmmm.....

Tuesday, January 19, 2010

California to Regulate Doctor Wait Times

Ok, here's an idea, have government mandate how long it takes for you to see a doctor. Don't believe it? Well, California, in their infinite wisdom, is doing just that. I read this story and it just made my skin crawl. It is from The Los Angeles Times and it is entitled, "California Limits HMO Wait Times."
The regulations by the California Department of Managed Health Care, in the works for much of the last decade, will require that patients be treated by HMO doctors within 10 business days of requesting an appointment, and by specialists within 15. Patients seeking urgent care that does not require prior authorization must be seen within 48 hours.

Telephone calls to doctors' offices will have to be returned within 30 minutes, and physicians or other health professionals will have to be available 24 hours a day. California says it is the first state to set time standards for HMOs, which serve nearly 21 million of its residents.
Now, the only people who think this is a good idea are politicians. I can just hear the meetings in the back rooms at the state house - "Well really stick it to those doctors with this one." Here's the simple question - Why does it take so long to see the doctor? The answer is simple - Government and Red Tape. The government created most of this mess - really.

Now, I don't practice in California, but I know where I live, there is form after form after form to be completed associated with patient care. Much of it is trying to keep with government regulations from the state capitol and from Washington. Plus, if anyone utters the words "Pre-Authorization" - they know how much time this takes from an office staff point of view. This useless time on the phone or on a computer could be better spent - Uh, taking care of patients.

So, here is a little tip to my friends at state legislative houses across the country, and in Washington. The best way to improve wait times and overall patient care, is not to increase government regulation, but to DE-REGULATE government control over health care. Not to mention, with this additional layer of government oversight, who is going to pay for this additional oversight with a bankrupt California budget? Did anyone ask that question? Probably not....

Social Media Suicide?

Ok, I admit that I got the following article after logging into twitter. This is from and the title is "How to Disappear from Facebook and Twitter." This kind of goes along with my previous post. But, then again, it does not. The article makes reference to a "suicide machine" which, in essence, scrubs your online identity from social media networks.
Since its Dec. 19 launch, Suicide Machine has assisted more than 1,000 virtual deaths, severing more than 80,500 friendships on Facebook and removing some 276,000 tweets from Twitter.

Once you hand over your log-in details and click Commit, the program will methodically delete your info — Twitter tweets, MySpace contacts, Facebook friends, LinkedIn connections — much like users could do manually. What remains is a brittle cyberskeleton: a profile with no data.
Now, don't worry. I'm not going anywhere (I think). I just thought it was kind of funny that I was talking about (trying) to take a little break from facebook and twitter, and then, this article comes along. Long Live Social Media!


So, for the last three days, I've been doing this silly experiment with myself (no not anything like that people - hehe). I have tried to unplug from twitter and facebook for a few days. Well, I have failed in one aspect in that I have been continuing to log into FB and twitter. And, I have commented on FB.

However, I have not placed an update or tweet for the past few days. And, let me tell you, it has been very difficult NOT to do that. I had been kind of weird, though, in that I have found myself getting back to this blog to write thoughts down - and it's been a good thing. (BTW, thanks for all the feedback as I have tried to get back into blogging).

I'm continuing to hold true and not do my live internet radio show for these two weeks. And, I'm doing ok (for now) in not posting any updates. It's silly, but getting out of one mind set, has shifted be into another mindset as far as "What am I going to blog about today?" The experiment continues.....

Monday, January 18, 2010


"Dr. A, your student is here," the front desk squawks through the intercom. "Sheesh," I say to myself as I look at my full schedule of patients. Now, don't get me wrong. I really enjoy teaching. Something I do know is that I could not do teaching full time. I thought about possibly joining a residency program or exploring the possibility of teaching full time at the med school. But, at this point in my career, patient care is still my passion.

What docs never say (in public) but always think is that students definitely slow down the productivity and efficiency of office hours. I mean, teaching does take a long time - at least being a good teacher or student "mentor." But, we all know that at one point in our medical career, we were that student who didn't know that much and were afraid to ask a "dumb" question.

My patients and my office staff are great in that they take things in stride. When I tell the same story for the 20th time to a new student in the office, they understand. I mean, hey, primary care is as much about the patient's story as it is about their medical conditions.

I don't think I influenced the student in choosing primary care as a career (not sure if that is even possible these days). But, at least I hope that I conveyed to this student that despite all the roadblocks in the way of doing my job (state/federal regulations, insurance companies, fear of frivolous lawsuits), I still love what I do (really) and I would choose this career path again....

Update: Greetings to those of you who clicked over from Better Health. If you enjoyed this post, I encourage you to check out other posts over here. Thanks for stopping by!

Sunday, January 17, 2010


It's been months since I have written any kind of significant blog post. I'm not really sure why. I could use the excuse that work is getting in the way, or life is getting in the way. But, I know that those are just poor excuses. I also know that if you don't write anything, no one reads the blog. I have seen my readership slowly dwindle over the past few months. Frankly speaking, I'm embarrassed to call my self a "blogger" these days.

The only way to get back writing - is to just write. So, that is what this post is about. What I hope to do is to try to find my blogging voice again. I have put so many road blocks in front of me and I have made so many excuses. It's time for me to stop making excuses and just writing something again. The funny thing is that I used to enjoy writing. It used to be a unique way for me to express myself.

So, I hope this post is a way for me to start over. A way for me to restart and jump start this blog again. I know where I want to go with this blog, and the direction that I want to take this. But, the only way to get there is to just start writing again. Thanks for your patience as I try to get back to where I was before on the blogging front....

Thursday, January 14, 2010

Show 140 Wrap-up: Chronicles of EMS

Thanks to Ted Setla from EMS Media for talking on Doctor Anonymous Show 140 about the new reality web series called "Chronicles of EMS." Our discussion started with us talking about Ted's background as a paramedic AND a filmmaker. We then went into the origins of the CoEMS project which started with a bunch of passionate people who wanted to share a point of view which has never been covered like this before.

According to their promo material, CoEMS is "a reality web series that travels the world exploring EMS systems, how they operate and the personalities behind them." If you haven't checked out the trailer/preview of the first show, you can check it out here. Our interview also covered how they are getting sponsorship for episodes and how a community really has come together around this show. They have masterfully used both social media solutions along with in-person meetups.

As always, you can listen to the show right here on the player above. You can also download the show and listen anytime by clicking here. Don't forget to check out my video post above. There were a few new listeners who checked out the show, and I just wanted to say thanks for stopping by!

Good luck to CoEMS on their premiere which will be Feb 12, 2010 at 5pm pacific time at their website. I wish I could be there for the in-person meetup. My next show will be Saturday, January 16, 2010 at 9pm ET. Hope you can be there!

Wednesday, January 13, 2010

Dr. A Show 140 Preview: Chronicles of EMS

Let me tell you about the power of social media. So, I was just listening to the live podcast called MedicCastLive and one of the panelists mentioned a new reality web series called Chronicles of EMS. Their promo based material calls CoEMS Chronicles "a reality web series that travels the world exploring EMS systems, how they operate and the personalities behind them."

This sounds very exciting! Our guest will be Thaddeus Setla from EMSMedia.TV to talk about the new series which will be premiering on Feburary 12, 2010 on EMSMedia.TV. You can see the trailer/preview of the first episode below. Let me tell you, the production value of the preview is top notch (as you'll see below). So, I'm looking forward to checking out this show.

I hope that you can join me on Thursday, January 14, 2010 at 9pm ET/6pm PT for Doctor Anonymous Show 140. In case you didn't know, in addition to the live podcast, there is a chat room, a webcam of me, and your ability to call into the show to say hello. Hope you can join us this week for the show!

Sunday, January 03, 2010

The Weight Loss Resolution

With the long holiday weekend coming to a close (at least for me), I'm looking at the prospect of returning to work tomorrow. Being four days into the new year tomorrow, probably one of the most common questions I get asked is the "magic" of losing weight fast. In addition, it's probably no coincidence that the reality show "The Biggest Loser" is making it's premiere for its latest season in the US on the January 5th, 2010.

I had the privilege of being asked by our local TV station here to talk about the dreaded "Weight Loss New Year's Resolution" that many people make but few people actually stick to (including myself - yeesh). I admit that I don't give the magic solution in either of these videos (above video link & below video link). However, I hope to give people at least some things to think about as they start the beginning of this year on the road to better health...

Saturday, January 02, 2010

Show 138 Wrap-up

Had a great time with Doctor Anonymous Show 138 tonight! I talked about some news stories (including Ohio State's win at the 2010 Rose Bowl) and midway through the show, our good friend Ben called in to chat. In addition, THE Burl checked in. And, to my pleasant surprise, BTR personality Dr. Blogstein called into the show to say hello - that is until his cell phone battery died (or so he said). All in all, not a bad show tonight. (also check out the video above which is the opening 5 minutes to the show)

As always, you can listen to the show right here on the player above. Or, if you like, you can download the show and listen anytime by clicking here. There will be no Thursday show next week. So, my next show will be Saturday, January 9th, 2010 at 9pm Eastern Time. Happy New Year everybody!

Show 137 Wrap-up: New Year's Eve 2009

I have never done a New Year's Eve show before. And, I have to admit that this was a great experience. Not only was I live on the air at midnight for the eastern time zone, I was also on the air live for midnight for the central time zone as well. It looked a lot more dramatic on TV, but in the video below, is my lack of enthusiasm as midnight struck in the eastern time zone. Also on the show with me at this time is our good friend FriggenBenQ.

If you have never listened to my internet radio show before, I encourage you to listen to the archived show in the player above. Or, if you like, you can download the show and listen anytime by clicking here. Thanks to Ben, Kim, and Dana for calling into the show and helping to keep me awake. Thanks as always for your support of the website and for the show! Happy New Year!