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COVID-19 Pandemic: 5 lessons about the way we practice medicine

I know that this blog was supposed to be Part 3 of the “building an academic portfolio during medical training” series, however, it’s very difficult these days to talk about anything other than COVID-19. This pandemic that has taken the whole world by storm, and reminded us all about how fragile our whole world is! Amidst all the angst and frustration, it is important to focus on positively learning from such an unprecedented experience in our lifetime. The lessons are innumerable, yet I wanted to share with you 5 points that, in my humble opinion, were highlighted by these extraordinary circumstances:

  1. Telehealth is no longer a luxury. Despite having the technology available for years, the health industry has been lagging behind when it comes to telehealth. It took a pandemic and thousands of lives for us to realize that most of the outpatient services we provide (and arguably some of the inpatient ones even) can safely be delivered virtually. The degree of disruption to one’s life and the time wasted outside the actual doctor’s visit, between taking time off from work, physically making it to the medical facility, parking, checking-in, and so forth, can easily be omitted by a technology that is readily available but we have been reluctant to use (or don’t have insurance approval to do so). There will always be a place for in-person visits, but at least we would have more time for patients that actually need to be seen in-person.
  2. Many hospitalizations and tests are unnecessary. As the pandemic worsens, physicians started to be judicious with ordering tests that require moving patients around the hospital. They also started thinking twice about who needs to be in the hospital, to begin with. We are now realizing how many tests and hospitalizations can safely be avoided, and I am hoping that we will carry these revelations with us as we move past the current circumstances.
  3. Incorporating research into clinical practice needs to be seamless. Despite major advances, the way we conduct research has not yet been optimally incorporated into our daily clinical activities. We are in desperate need to develop the necessary infrastructure that instantaneously translates patient-care input into organized data that can be used to improve the way we manage our patients. Ideally quickly enough to potentially help some of the patients who generated these data. This necessary infrastructure also extends to research regulations, which need to strike the appropriate balance between scrutiny and practicality.
  4. In a world of “evidence-based medicine”, clinical acumen remains paramount. The sudden exposure to this COVID-19 pandemic has reminded us all that often times, as physicians, we are required to operate in evidence-free zones. As much as we need to always look for evidence behind everything we do in medicine, it is essential not to forget that taking care of patients is both a science and an art. And this is why physicians can never be replaced by computers.
  5. Prevention is ALWAYS better than cure. With the great technological and pharmaceutical advances, we tend to develop great confidence in our ability to improve life expectancy. This is particularly true in procedural fields such as Cardiology. Then comes a sobering pandemic, to remind us that when it comes to public health, prevention always wins! Fortunately, we rarely need drastic measures such as quarantines and social distancing. But addressing smoking, obesity and blood pressure control will always have much more impact on our community than stents and ablations.

We will continue to learn from this world tragedy – lessons in medicine, philosophy and life in general. But, above all, this is a reminder of how noble and unique our healthcare profession is. Stay safe everyone!

“The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.”

 

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How to Shine the Light on Hidden Figures in Science and Medicine

March is Women’s History month and like last year, I wanted to find a way to use this blog as a way to highlight some amazing women scientists and cardiologists. When writing my piece last year, I had a really hard time finding enough information about trailblazing women in cardiology — which was incredibly frustrating since we all know women are a driving force in our field.

I then came to realize, although I wasn’t surprised, that this isn’t specific to our field. One of the main reasons it was hard to make a list of notable women in cardiology is that less than 20% of Wikipedia articles are about women. Even Marie Curie shared her Wikipedia biography with her husband until recently. If winning a Nobel Prize doesn’t make you worthy of your own Wikipedia page, I’m not sure what does. This bias has become an issue in part because most of Wikipedia editors are men.

So, how do we fix this? What can you do?

It turns out, the answer to these questions is actually really easy! Since anyone can become an editor on Wikipedia, you yourself can edit or write pages for notable women and other under-represented scientists/physicians. This practice has actually become a popular grassroots movement, with Women in STEM Wikipedia-edit-a-thons sprouting up all over the country — I’ve been to three in the last year!

One of the main drivers of this movement is a physicist at Imperial College London, Dr. Jess Wade, has written over 900 biographies on Wikipedia in just the last couple of years. While writing almost a thousand articles seems a bit overwhelming, you can easily edit a page you think deserves to be beefed up or create one of your own by following this beginner’s guide, which also includes information about how to run your own edit-a-thon if you know of others who are interested. Writing with friends is always more fun. The last edit-a-thon focused on creating pages for under-represented scientists that I attended was this past weekend on International Women’s Day and had a wonderful keynote address from Dr.Maryam Zaringhalam, who has been another driver of making Wikipedia a more inclusive space. In just a couple of hours at this edit-a-thon we added 5 new biographies, made over 200 edits and added over 12,000 words to Wikipedia! This was just our group — on this day, there were actually more than 12 other groups working with us virtually and collectively we added over 60,000 words to Wikipedia. You can actually catch the livestream of this event, including Dr. Zaringhalam’s phenomenal keynote here.

So this Women’s History Month, take action to make our community more inclusive by starting with the internet — it’s easy, rewarding and fun, I promise!

“The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.”

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Why Advocacy is Critical for the Future of Cardiovascular Research & Medicine

As researchers and physicians, many of us got in to our professions to push the scientific enterprise further to ultimately help others. We’ve all trained for an insane amount of years and collectively we work as a unit to uncover the intricacies of the cardiovascular system, develop therapeutics and treat patients. We traditionally think of ourselves as researchers or physicians first, but obviously we are all so much more than our jobs. We are also citizens within a really complex system that has been continually struggling to serve all of its citizens equally. It’s no secret that access to affordable health care is currently not equitable within our society. Similarly, there are also large diversity & inclusivity issues within our training institutions for both researchers and physicians.

However, something we don’t think about enough is that our intensive training and experience within these systems has also prepared us to be effective advocates for these issues. We have the opportunity to promote tangible change and some might argue it’s even our responsibility.

One of the things I really appreciate about being apart of the American Heart Association (AHA) is that this is something the organization doesn’t shy away from. During his presidential address at AHA Scientific Sessions 2018, Dr. Ivor Benjamin gave a heartfelt and determined talk about what the future of the AHA’s advocacy mission looks like. He discussed how supporting local and federal advocacy, early careers and mentoring is key to supporting the future of the AHA – but only 3% of cardiac professionals are African American men and this is something the AHA wants to help change. To help solve the diversity and inclusivity issues within the cardiac field, the AHA is expanding major undergraduate initiatives to fix the leaky pipeline. My favorite part of Dr. Benjamin’s talk was when he urged everyone at AHA18 to get involved in advocacy, not just for our field, but also for our communities. Because this is the key point: in order for our work to have meaning and to be effective, we need to ensure our communities are healthy. We also need to put value to advocacy efforts in our field – this is an essential part of our profession.

Well, this is all great, but how can you get involved? We are all insanely busy; I know adding advocacy efforts can seem daunting. Luckily for all of us, one of the focuses of the AHA for January is Advocacy. Since over 7 million Americans with cardiovascular disease are currently uninsured, advocating for the protection of the Affordable Care Act is something we can all do from our computers right now.

How can you help? (Provided by the AHA newsroom)

https://www.heart.org/en/get-involved/advocate/state-issues

 

Looking for more ways to help on other issues?

  • The AHA has a great advocacy resource page for to get involved with efforts at the federal, state and community levels with issues regarding health care, tobacco prevention, and healthy lifestyles for kids.
  • Sign up here to become part of the AHA’s grassroots network, You’re the Cure, which is focused on advocating for heart-healthy and stroke-smart communities.
  • There are many great non-profits around the country focused on promoting science funding, literacy, inclusion, diversity & advocacy – finding the right one for you is key and many of them have already done the legwork by developing toolkits for you to get started in your community.
  • Interested in STEM outreach as a way to get involved in your community? The great Marian Wright Edelman said, “You can’t be what you can’t see.” Participating in local educational initiatives is one of the best ways to expose kids to what scientists and physicians actually look like (in addition to getting them excited about science). The STEM Ecosystem is a great way to get started; there are local chapters all over the country.

I recently watched the brilliant documentary (I highly recommend it!) about Mr. Rogers, “Won’t You Be My Neighbor”, where I was reminded of his advice many of us take comfort in during intense times.

“When I was a boy and I would see scary things in the news, my mother would say to me, “Look for the helpers. You will always find people who are helping.” – Mr. Rogers

We are the helpers. Its time we use our power to advocate for equity within our field and communities.