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  • Web and health 2.0 : What is web 2.0 to us physicians?

    I’ve been asked several times by colleagues and friends alike what do I get from blogging and joining social networks as a physician-surgeon. My honest to goodness answer was,

    I’m dabbling at web 2.0 tools to enhance my practice, my delivery of health care and sometimes, earn from sponsored ads.

    I get blank stares when I mentioned web 2.0 but the words “earn” seem to catch astute ears. I usually don’t get enough talking time to expound on this, especially with the web 2.0 and health 2.0 part. Thus, I am making a series of posts to elucidate what web 2.0 is to us physicians and how is it changing the medical practice and our delivery of health care. (Forget the earning part, the web is replete with how-tos on this topic)

    I must warn physicians reading these series of posts, that even if I try to be as concise and simple in my explanations, a few thoughts may sound technical to those unfamiliar with the digital lingo. Try copying the word or phrase that you don’t understand and place it in the Google search bar and click search. You will be surprised by the heaps of explanations and answers to your queries.

    I understand that despite the increasing trend of physicians using the internet, most physicians here in my country knew a little beyond emails, online medical and entertainment news (please correct me if I’m wrong here). A few, more engaging doctors knew about the powers of Google-ing. But learning web 2.0 (and its tools) to enhance your practice will need a lot more than line reading and the “I’m always busy I don’t have time for this” attitude most physicians here succumbed. If this is your learning perspective, I suggest you don’t bother reading this post and return to your usual mode of practice and lose an opportunity to enhance your delivery of health care. You wouldn’t even know what you’ve missed anyway.

    Going back, here are the basic questions I’ll try to answer:

    1. Whats web 2.0 anyway?
    2. How is it different from web 1.0?
    3. What are those web 2.0 tools you are talking about?
    4. Whats web 2.0 to medicine and how is it changing the medscape?
    5. Is it here to stay or will there be a web 3.0 and so on?

    I’ll answer the first two question in this post and the other questions in my succeeding posts related to web and health 2.0

    Web 2.0 is a concept (or a tool) describing the use of internet (world wide web) and web designs (or platforms) to ENHANCE creativity, communication, collaboration, sharing, security and functionality of the internet. I also must add that this concept imply that such tools will be used to attain certain goals that may differ (or converge) to many individuals or groups taking advantage of it. Improvement of health care delivery is just one of it. Here’s a sideshow of what web 2.0 is all about.

    Web 2.0

    View more presentations from satyajeet_02. (tags: internet 2.o)

    Ironically, web 1.0 ‘s definition is an offshoot of web 2.0- to contrast what web 2.0 is all about. But the salient points are ; web 1.0 is static, not interactive and is proprietary. Note the direct contrast of these two concepts. Nonetheless, it is safe to say web 2.0 is an evolutionary cousin ( or revolution) of web 1.0 in the net.

    Take note of the words internet collaboration, improvement and user empowerment. Democratization of the net is another personality of this concept. To some these are the distinction of web 2.0 to web 1.0. And that’s where the powers of web 2.0 lies. It is within our capabilities as physicians to grab this tool and opportunity to improve our practice and delivery of health care.

    This answer the queries what physicians can do with their online: No it’s not just about advertising your profiles and online directories. It’s not just emails and one way communication. It’s not even just the act of putting up a website for your practice and doing nothing about it. More than that,Web 2.0 tools allows us better collaboration, communication, feedback (between patients and physicians for example) and improvement of health services. And here in the Philippines, we haven’t taken off from web 1.0 yet!

    I’ll discus web 2.0 tools in my subsequent posts.

    (For additional readings on web 2.0 read the web 2.0 wiki or O’Reilly Media’s article on web 2.0. For articles regarding internet usage of physicians, kindly read the results of this research)

  • The Blog Rounds 28th ed: Top Ten Movies for docs!

    Who says docs don’t scorn the big screen? The latest edition of The Blog Rounds tells us there’s more to the clinics and operating rooms for the stet users. A menacingly titled edition  “Tell me your top ten moves and I tell you who you are” brings the spotlight to docs and their favorite movies. Doc Mel (The Philippine Daily Idiot) this edition host tried sorting out personalities from the kind of movies listed. At least that ‘s what the host intend to. Read here and you’ll enjoy how movies shaped our doc’s personality.

    The next edition of TBR will be hosted by Em Dy (Pulse) and will deal with our hearts health!

    The Blog Rounds is a biweekly compilation of the best in Philippine’s medical blogosphere, written by physician bloggers (or the medically inclined bloggers) and hosted on a participating blogger’s weblog. Archives and edition schedules ( plus the host blogger) are listed here. The next edition of TBR will be up this Tuesday, Feb 2 ,2008 7am PST.

    Physicians and medically inclined bloggers interested in joining this blog carnival, please contact me through my email kokegulper[at]yahoo[dot]com or any of the participating TBR bloggers. Guidelines and updates are posted here in my website, The Orthopedic Logbook.

  • Ban all forms of fireworks!

    That’s all the solution to the injuries inflicted by all forms of fireworks.

    The year in and year out reports of firecracker injuries dropping significantly by the year, under the present regulated law on “responsible” use of firecrackers, is hogwash. I have read that kind of news since I was in third grade, through my med school, and even after my orthopedic residency.

    Still, how many hands and fingers have we amputated each year? How many lives are still to be taken before we say, “Stop this crack!” It’s always too late to cry (and too hard by the way) when you wipe your tears with an amputated hand, mind you.

    The question really boils down to why our legislators could not pass a legislation and the government imposing a total ban on all form of firecrackers. Is it the taxes they pay? The jobs they provide? The earnings the firecracker and manufacturers get? Ever tried to account how much the government is spending (DOH Kontrapaputok or hospitalization) on injuries caused by this firecrackers?Of the personnel we “force” to take care of them instead rather than those disease we don’t have any control of? Of the functional lost and disability this people will incur? Read the real data on these fact legislators and maybe it’ll clear up your mind.

    The success that the city of Davao has implemented this total ban on firecrackers since 2002 made me think its really a matter of policy and political will. I (who was trained in another medical center in Manila) actually is too surprised and happy that as of the last orthopedic conference in the biggest medical center in Davao City (where I now belong), we don’t have any firecracker injuries to manage!And Davao City people (except for a few unscrupulous citizens now languishing in jail) has live that way since 2002!

    I laud the DOH and secretary Francisco Duque III for pushing (an amendment to RA 7183) for a total ban on all forms of firecrackers in the Philippines. From the perspective of health care, efficiency of providing services and the health of our eardrums, hands and our lives, such  ban is the best new year news we can get!

  • Superdocs and super (freeloader) patients…

    I’ve seen these type of patients( commonly called a freeloader) since I was a neophyte in the practice of medicine- in the corridors, the cafeteria, the laboratory, at Wendys, or even at the malls(yes, MDs got to the malls too, sometimes). The common profile of such patients is someone you know or got acquainted to, not long ago or through another known person. The ambush interrogation is a classic “guerrilla consult” aimed (intentionally or unintentionally) at defying conventional ethics and procedures to get an MD consult on something the patient felt so “urgent. By some cultural and social magnet, you give in to the pleading, even if you felt the “problem” may not be closed to an emergent case by some medical standards.

    You come up with your most empathic diagnosis and advice in such a short time, based on the history of the person. With not even a word of “thank you” or whatever, the person suddenly disappears without any follow up or news about his consult whatsoever. The next time you bump with these types of patients, they suddenly go amnesic of their last “consult”. Somehow you learned from that previous consult that none of your advices where followed or was totally ignored. The “patient” now is hurling another totally different but accurately detailed problem for consult. This cycle goes on and the guerrilla consults is repeated.

    This is the question thrown to me by one colleague obviously exasperated by the misuse of this “tactics”. New to this Pinoy culture and habit of “pakikisama”, he mentioned such habit is often difficult to handle and often end in an unsatisfactory doctor patient relationship. I’ve came across this same problem in one forum also.

    I’m new to practice, but I’ve been encountering such “patients” quite often too. Here are the policies I’m currently implementing whenever I encounter such patients. They may not work all the time, but they might work for you!

    1. Be courteous and empathic all the time. If you get irritated because of past encounters that was so frustrating, keep it to yourself or discuss it with your patient on a proper venue and time and that will be in your office clinic.
    2. Make a quick assessment and decision to determine if the patient has an emergent or urgent problem or something that can wait long enough to see the patient in your clinic at a proper time.
    3. If the problem is emergent or urgent, courteously refer the patient to the ER or to appropriate specialist. Otherwise,
    4. Schedule an appointment time for the patient in your clinic. Explain the scenario to your patient as quickly and as courteously as possible. Most of this haphazard doctor patient consult end up in a very unsatisfactory treatment for the patient. Let the patient understand that.
    5. Unless another emergent problem come up, stick to your clinic schedule for that patient and hold advices and recommendation till that moment. Being patient often gets the better part of treatment.
    6. Make sure the patient know the schedule and the importance of the scheduled consult. And also make sure the patient come to that appointment.
    7. If the patient does not show up for that consult for some trivial reasons, politely begged off the doctor patient relationship and refer the patient to another appropriate physician or for counseling.

    These are the things I do to patients who hound me as chronic “freeloaders”. I often don’t reach the number seven advice, but I felt such steps will be necessary to help the patient and make him/her understand the problem he is causing.

    If you were in our place, what would you do?

    Handling these type of patients hopefully will qualify you to the SuperDoctor list like this one…

    (Featured photo lifted from The Blog That Ate Manhattan, here)

  • Ebola Virus Reston Strain in hogs: Should we be alarmed?

    Frankly, to some degree, I am.

    Had it not been for an item in one newspaper and Google Health Maps, I would have left this story to the epidemiologist and infectious disease experts and enjoy Pacquiao’s glamorous boxing stints. But this news pinched an area of my curiosity.

    Pigs in three Philippine hog farms have been found infected with the Ebola Reston virus, a strain not harmful to humans, officials say.-9News Australia


    This strain of Ebola virus (Reston) was previously known to infect monkeys and Department of Agriculture secretary Arthur Yap assured Filipinos this Ebola strain is non pathogenic to humans.

    However, following the news items “anchored” on the Philippines’ Google health map location, suggest that much is still unknown of this Ebola strain.

    1. Where is the reservoir host of this strain? The reservoir host has not been identified since it was discovered more than a decade ago.
    2. Why is there a cross specie infection now? It was thought to be affecting monkeys before and now it was documented to infect hogs!
    3. Years ago, some people tested positive for antibodies (seroconversion) against this strain of Ebola. They did not fell ill however. No explanations for this yet.
    4. This Ebola Reston Virus was detected from hogs coming from the Philippines and exported to US. The implication was, our DA and DOH did not detect the “recurrence?” of this strain until their US counterparts did!
    5. How come the US inspected and tested hogs from the Philippines when it was known to infect monkeys before? Is this routine testing protocol or were they suspecting something else???

    I can come up more with more scary questions but the bottom line is- we should be vigilant and take precautionary measures against this “potential” threat. While we don’t want to pull down the market of our hog industry because of bad publicity, we cannot let our guard off for some potentially unknown enemy. It has been recurring for decades, who knows what happened in between those decades.

    Update: The following news from The Wall Street Journal and ABS CBN News tell us that it was as early as oct 30, 2008 where the ebola virus was found but announcement by DA was only made Dec 10,2008.