ICYMI – In Case You Missed It – November 2015 – for Physicians and Physician Leaders

The people who are crazy enough to think they can change the world are the ones who do. — Steve Jobs

Health Care

• Getting specialty care consultation real-time in a primary care office is no longer exclusive to integrated healthcare organizations like Kaiser Permanente or Mayo Clinic. Startup Remedy Labs offers access to Orthopedic Surgery, Dermatology, Cardiology, Endocrinology, and GI.  It won’t be the only one.
• At any startup we hear the term MVP all the time. At a large organization, I heard “We have to disrupt ourselves before the market does.” How do you get a startup mindset inside a large organization? From HBR – 4 Tips for Launching Minimum Viable Products (MVP) Inside Big Companies AND 5 simple questions to ask front line doctors to spark innovation! – How Brigham & Women’s Funds Health Care Innovation.
• Dermatoscopes allow dermatologists to diagnose melanoma better than the naked eye. This Indiegogo crowd funding campaign for HUD has a dermatoscope attachment to an iPhone for only $70.  Developed by the team that did the First Derm app, HUD will allow patients to photograph high quality images using a dermatoscope to send to dermatologists. For a Kaiser Permanente, one can imagine giving / subsidizing the HUD dermatoscope to patients diagnosed with melanoma, ask them to annually or more frequently send images of worrisome spots which allow for more continuous care rather than the annual skin exam. Patients have more piece of mind, convenience, and control. Dermatologists have a more complete record of the patient and can increase the precision of when patients need to be seen and when they do not. This also could help solve the issue of there are not enough dermatologists nationally to handle the number of increasing skin cancer cases.
• As noted in the previous ICYMI, the next biggest challenge for health care is misdiagnosis. Figuring out what the right diagnosis, testing, and treatment correctly the first time can save time and money. How does one get the collective knowledge of doctors (network effects – the larger the network, the more each person benefits – think Facebook) to provide the most up to date and just in time information to a doctor? Here is one solution by Visual Dx. 

• Figuring out how to access and interpret all that data is not a skill that most physicians learned in medical school — but that’s changing…first and second year students at the NYU School of Medicine is required to do what’s called a ‘health care by the numbers’ project…Medical Students Crunch Big Data To Spot Health Trends from NPR. Yet will millennial doctors who are more tech savvy be better doctors? I’m not sure…. Without a doubt, in the future there will need to be a doctor who is an analyst of big data to help front line doctors interpret and then act on the information. UCSF Professor Bob Wachter and author of the book The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age has suggested that medicine may need a new kind of doctor, a digitalist.

Outside Health Care

• Remember the mysterious Malaysia flight MH370 disappearance in March 2014 that continues to have no explanation or evidence? Unlike initial accusations of malicious intent by the pilot, UFOs, and terrorism, nearly 1 1/2 years later this analysis is far and away is the most thoughtful and likely. The Deadly Cargo Inside MH370: Exploding Batteries Explain the Mystery.  As relatively easier problems are solved (making airplanes and flight crews highly reliable and safe), problems and issues that do arise surface will be more complex and difficult to solve.  Who will spend the time to do the deep thinking and analysis that gets to the truth and avoid the inevitable human nature of finding quick solutions simply by loose association of facts?
• Now I know what “hard-wired” really means! Her Code Got Humans on the Moon—And Invented Software Itself.
• Always thought provoking piece from Malcolm Gladwell. What is your “threshold” for deviant behavior? From the New Yorker,  Thresholds of Violence – How school shootings catch on.
• Very worrisome. Asking for feedback and rating service can be good. However not done thoughtfully, is this simply a race to the bottom? The rating game: How Uber and its peers turned us into horrible bosses. As noted in the prior ICYMI, is the world becoming the “gig” economy and people having fewer protections like health insurance or financial security?  “We’re not just working for money,” an Uber driver told me. “We’re working for ratings, but ratings have no value. Ratings serve only to prevent you from getting fired. Only bad things can happen to you. We’re scurrying like rats after these things with no value.”

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  New technology allows air traffic controllers to land planes from a windowless room hundreds of miles away. (Photo: Saab AB)

• Scary or awesome? — Virtual Air Traffic Control Is Now a Thing. 

Personal

• Raising two children today can be hard. This report is pretty insane. Teens spend a ‘mind-boggling’ 9 hours a day using media, report says. Will they have the ability to solve complex issues society faces if they cannot too deep concentrated thought?
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• Whether you agree or disagree with President Obama, he has plenty of insights in his interview with Bill Simmons. One in particular regarding social media is an area which every leader in any organization must develop expertise. Otherwise without it, the ability to develop a brand and consistent message as well as creating a narrative is lost in a society increasingly fragmented in how they access and consume information.
• You win the election in 2008, and Twitter is just becoming a thing. Over the course of your presidency, that’s the biggest thing that’s changed. What’s the biggest challenge with all that stuff?
• Speed. You are on 24/7—you have to respond immediately. The job of our office, to keep up and to respond quickly to anything that’s happening but not be consumed by it, is completely different. We’ve been building a digital team inside the White House.
• When did that start?
• Too late. That’s an example of something that I would’ve started earlier. That was a lesson that coming out of the first term, I should’ve understood. That’s why we built this team. It’s so interesting watching my daughters. Both are complete ninjas on the phone, right? And they can do things that I don’t even understand—they’re doing it in two seconds. But I even see a difference between Malia, who’s 17, and Sasha, who’s 14. There’s almost a mini-generational gap in terms of Sasha being so connected seamlessly to this smartphone in a way that Malia, who was already a little bit older when it really started to take, is not.
• The ability to multitask with 19 different friends at the same time…
• Yeah. And just the degree to which her social life is so connected to that. So it’s not just having to change how we do business inside the White House to react to stories, but also, how do we tell a story about issues to constituencies that are completely splintered, who don’t watch television in the same way, who don’t watch the news in the same way? In some ways we’re just laying the foundation for what I assume will be the standard practice of future presidents.

• BACK TO THE FUTURE is 30 years old. Documentary Back in Time (available on Netflix) highlights how this film is “the nearly perfect film” with a script that defies the common Hollywood convention of a story arc taught by Bob McKee, the tough judgment call by directors to replace Eric Roberts with Michael J Fox, and how no one wanted to produce this film. In 1985, writers got a lot of predictions for 2015 right (drones taking photos for news, 1980s themed restaurants, video conferencing at home, magnetic hoverboards) . What will the next 30 years bring? People will own fewer things and work will be decentralized.

What did I miss? What else would you add? 

Previous ICYMI – October 2015