Remember Me?

Man … it’s been a while.

When you’re in school enough hours per week to call it a full time job, other things fall by the wayside. Like the cups and plates stacked in my sink. Like the girlfriend I see those one or two times a day I look up from my textbook. And certainly, the blog where I’d naively hoped to chronicle the daily experience of it all.

If anything, the silence on this page in recent…

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It’s been a whirlwind experience in this first week of medical school as we’ve examined “The Foundations of the Profession.” Here are my thoughts on our first week, what it means to be a healthcare provider, and the path that lies ahead!


amolutrankar and kvnwng, my co-hosts at the H&P, got a chance to interview one of Tumblr’s favorite docs, cranquis! Check out this hilarious interview with the good doctor (his voice has been altered to protect his anonymity) and let us know how we’re doing with the podcast! Remember to give us 5 stars on iTunes so we can continue producing!

A new episode of The H&P is now live, and we hope you’ll love listening to this one as much as we enjoyed recording it!

If you have any feedback or suggestions for us, reach out to us via social media, or tell us what you think by rating us on iTunes. We’d also love to hear if you have any suggestions for guests or topics!

Here’s another essay I wrote a few years ago about a particularly memorable patient encounter and the challenges of handling clinical situations that require us to operate beyond our training, outside our natural comfort zone.


We would like to announce our new podcast “History & Physical,” hosted by Kevin Wang (wang-kevin), Amol Utrankar (amolutrankar) and Roheet Kakaday (thebiopsy).

The podcast aims to answer to question: “What does it mean to be a medical student of the 21st century?”

Listen to the first episode here or subscribe on iTunes.

Proud to be part of this exciting new collaboration! Pardon the cliche, but we genuinely want this to be a podcast by medical students, for medical students - so if you have any feedback, suggestions, or ideas for future episodes, do reach out!

Presenting Com(med)ore, a chronicle of my medical school experiences from White Coat Ceremony to Match Day. Of course, I’ll still keep on ‘medblr-ing’ about policy, technology, and the future of medicine, and continue to explore new directions for this Tumblr, but this is my foray—an experiment, if you will—into a less editorial and more narrative-reflective form of blogging.


After transforming the fields of personal computing, digital music, and mobile technology, Apple has set its sights on the next frontier: healthcare. With HealthKit, Apple’s new health tracking platform for iOS 8, wearable devices and mobile health are finally moving into the mainstream. It’s here, and it’s now.

For doctors, patients, and students, this could be a game-changer. Imagine a future where your vital signs, diet, and physical activity are monitored 24/7. Where your primary care physician can review your health behaviors and make constructive recommendations. Where your caregiver can receive a push notification for an abnormal reading and follow up instantly. Where practicing medicine isn’t just about treating disease in the hospital, but ensuring health in the community.

On the heels of its foray into healthcare, Apple’s new ad, “Strength,” presents its vision of the future—one in which a mobile phone isn’t simply an accessory, but an extension of the self. A fitness coach. An activity tracker. A digital repository for everything you are in everything you do, quantified, analyzed, and chronicled.

And while I’m optimistic about the opportunities, I’m also .. not. Because of our health system’s core concerns, Apple customers—the affluent, the young professionals, the tech-savvy, the socially privileged—rank at the bottom. Apple’s ad is empowering, but it’s also disheartening, because it points to a future in which our best efforts are being put towards our mildest challenges.

The conversation about quantified self and mobile health should not center on the needs of wellness-enthusiast yuppies, but about how we can use digital technologies to reach out to those our health system has currently marginalized. The people who need HealthKit the most aren’t the people in this ad, but those who all too-often fall through the health system’s cracks: the frequent flyers, the chronically ill, the uninsured and under-resourced.

Naturally, I can’t expect Apple, Samsung, or Google to concentrate their efforts on these populations anytime soon; after all, there’s no profit motive. But for physicians, social entrepreneurs, and digital health innovators, we have to redirect our efforts to address the challenges where they are most severe.

Call it the ‘ivory tower,’ visualized. According to the World Bank, a third of its online research reports are never downloaded, and only 13% are read by more than 250 users.

From the Washington Post:

It’s fair to assume that many big-idea reports with lofty goals to elevate the public discourse never get read by anyone other than the report writer and maybe an editor or two. Maybe the author’s spouse. Or mom.

Academic researchers are trained to excel in knowledge production, but what we need today is content translation: the ability to communicate one’s work to a public audience and to be an evidence-based advocate for social impact.

As an undergraduate researcher, I’ve interviewed scientists to understand how they see their role as leaders and influencers of society. Too often, the answer is  ”I produce the data; others draw conclusions and create policy.” Which doesn’t work if your data aren’t being seen or heard.

Medicine holds the unique privilege of sitting at the intersection of inquiry, practice, and advocacy. As aspiring physicians, it’s essential that our training not only cover how to conduct academic inquiry, but how to connect our insights to the broader public.


Dr. Jordan Grumet on why public storytelling matters in medicine. Lots of lessons to tease out here.

If you’ve read Dr. Grumet’s blog, you know that he has an incredibly moving, profoundly poetic way with words. Likewise, this talk from DotMed 2013 communicates a vulnerability, a passion that leaves the viewer speechless.

Incredible. This is, without a doubt, a must-watch.

Most of all, I love this (at 15:02):

We do such a good job of using social media and the Internet to tell people what we know, but we do a lousy job of telling people who we are.

So often, when we talk about Health 2.0, and participatory medicine, and patient empowerment, we focus on the leveling of the doctor-patient relationship through the elevation of the patient’s role. What Dr. Grumet brings to light here is that the ‘leveling’ is bidirectional. Digital dialogue affords doctors a chance to step off the pedestal, to extend empathy and reveal to the patient a caring self.

The compressed moments of clinical encounters rarely allow providers the time to tell a story; they scarcely have the time to elicit one. With emerging channels of doctor-patient communicationblogging, Twitter, Youtube, and moreproviders have the opportunity to change their approach from an interview to a conversation. Caring 2.0 - I love it.

What Can Jeff Bezos Teach Medicine?

I’ve just finished reading Brad Stone’s The Everything Store, a biography of Jeff Bezos and an entertaining chronicle of Amazon’s rise from retail startup to e-commerce giant. If you’re particularly interested in entrepreneurship, organizational leadership, or technology, you might find it a worthwhile read.

Iconic Silicon Valley thinkers are often typecast as extraordinarily visionary, wildly daring, and socially adrift, and Amazon’s Jeff Bezos is no exception to the rule. If Amazon hadn’t become so unbelievably successful, Bezos’ notable Jeffisms might otherwise have been remembered as insanity, rather than prophecy.

To anyone in healthcare, Bezos’ resilience, boldness, and quixotic spirit might represent the antithesis of medical thinking. And while startups and medical centers could not be more dissimilar, The Everything Store offers real insight for healthcare leadership:

  1. It’s all about the patient. Despite its ubiquity and prominence, Amazon’s profit margins remain infamously anemic. Why? Because consumer satisfaction is Jeff Bezos’ primary business strategy. Low prices drive loyalty, which drives reliance, which drives profitability. Bezos’ vision: “We don’t make money when we sell things. We make money when we help consumers make purchase decisions.” How might we impart a similar alignment of business-consumer interests in healthcare?
  2. Aspire to perpetually self-disrupt. Amazon exec Diego Piacentini observed, “It is far better to cannibalize yourself than to have someone else do it.” Indeed, successful businesses too often fail to anticipate disruptive trends on the horizon, eventually falling prey to market shifts. Amazon’s success as a tech mainstay is largely due to its constant reinvention; that a books and DVDs retailer anticipated its demise and pioneered tablets and cloud consumption is remarkable. Are the traditional institutions in healthcare ready for the disruptive threats of the 21st century, and can they innovate to survive?
  3. Your people matter, too. Not all in Seattle is good, though. The fuel to Amazon’s meteoric rise is its workforce, notably driven by its CEO’s ferocity and expectations of excellence. Brad Stone’s narrative reveals a Jeff Bezos so consumed by aspiration as to foster a culture of perfection, an intolerance of error. The numbers agree; the average employee stays at Amazon for 14 months, putting the firm third-lowest in the Fortune 500 for employee turnover. Medicine is no newcomer to provider burnout, a culture of overwork, and a pressure to constantly perform at the highest level. Can the healthcare system deliver in outcomes and quality while preserving its core structure, the people?

Naturally, the extension of startup thinking to healthcare has its limits. Rapid innovation and bold experimentation might win the day in Silicon Valley; in the clinic, adopting practices without evidence or making mistakes can mean lives lost. But in an industry where pagers are the communication standard, where EMRs resemble vestiges of Windows 95, where incentives are wired for volume rather than quality, perhaps we can take a page out of Jeff Bezos’ book.

As for The Everything Store, I’d recommend it as a riveting story for those who enjoyed Nick Bilton’s Hatching Twitter or Aaron Sorkin’s The Social Network. If you’re looking for a more thorough discussion of technological and sociological implications of Amazon’s advances or as a guidebook for managerial strategy, though, this probably isn’t your cup of tea.

Reading suggestions are always welcomed via email, Twitter, or the “Ask Me” feature on the blog header!