At the turn of the 20th century, we built a healthcare system on responding to acute, curative, episodic issues. This system saw the eradication of many diseases and the advent of vaccinations and new treatments. The model was truly developed to be a “sickcare system,” which was what we needed at the time, and saw huge successes.
Fast forward 100 years and Americans are sicker than ever — but with different illnesses. What’s more, there is finally a national consensus that our healthcare system is broken. With increasingly tragic consequences, the reactionary medical paradigm has not provided the preventive care or chronic illness management that our culture needs. Healthcare spending currently consumes 17 percent of our GDP and without a radical shift in thinking, this number may grow even higher.
Sadly, patients are not the only ones suffering. The status quo is breeding a morale crisis among our nation’s doctors. If you asked one of the many thousands of medical students who are just beginning their fall semester why they chose medicine, many of them would give you confused, anxious responses about the field they are entering. This does not bode well for the health of future generations.
Last Spring, we met at TEDMED, an annual “grand gathering” in Washington, DC where forward thinkers from all sectors explore the promise of technology and the potential of human achievement as it pertains to health and medicine. Here, we presented our respective positions. One of us, Ali, argued that new technologies will actively change our health behavior. Another, Sunny, argued that we needed systems thinking in public health, focusing on the causes of the causes. Yet another, Jacob, argued for stopping the “imaginectomies” and fostering creativity in medical training by rethinking selection criteria and curricula for entrance to medical school.
Continue reading “Designing the Doctor of the Future”
Filed Under: THCB
Tagged: Ali Ansary, FutureMed, Jacob Scott, Sundeep Kishore, TEDMED, Tomorrow's Doctor
Apr 14, 2013
Our family debates a lot of things over our dinner table – the best Looney Toon character, politics, whether or not (and where or when) something is appropriate… For many of these topics, there are no right answers and no wrong answers – just a whole lot of discussion and opinions.
A few months ago, on the heels of the Health 2.0 conference, a small group of us gathered in a San Francisco kitchen for one of the most powerful experiences most of us had ever had around a dinner table.
Continue reading “Let’s Have Dinner and Talk About Death”
Filed Under: THCB
Tagged: Alexandra Drane, Death Dinner, End of life decisions, Engage with Grace, Health 2.0, Michael Hebb, Scott Macklin, TEDMED, TEDMED 2013
Mar 21, 2013
“What does the 21st Century Physician look like?”
Lisa Fields (@PracticalWisdom) cc’ed me on a tweet about this; it’s the featured question at www.tomorrowsdoctor.org, an organization founded by three young professionals who spoke at TEDMED last year.
I’ll admit that the question on the face of it struck me as a bit absurd, especially when juxtaposed with the term “tomorrow’s doctor.”
Tomorrow’s doctor needs to be doing a much better job of dealing with today’s medical challenges, because they will all be still here tomorrow. (Duh!) And the day after tomorrow.
(As for the 21st century in general, given the speed at which things are changing around us, seems hard to predict what we’ll be doing by 2050. I think it’s likely that we’ll still end up needing to take care of elderly people with physical and cognitive limitations but I sincerely hope medication management won’t still be a big problem. That I do expect technology to solve.)
After looking at the related Huffington Post piece, however, I realized that this trio really seems to be thinking about how medical education should be changed and improved. In which case, I kind of think they should change their organization’s name to “Next Decade’s Doctor,” but I can see how that perhaps might not sound catchy enough.
Continue reading “What Will Tomorrow’s Doctor Look Like?”
Filed Under: Physicians, THCB
Tagged: CQI, e-patients, FutureMed, Leslie Kernisan, Medical Education, OpenNotes, PDSA, practice of medicine, Quality, shared decision making, TEDMED
Mar 8, 2013
Last week I found my usually-diverse Twitter feed had coalesced into a single hashtag, the trolley buses chugging through the streets of Washington, D.C. were sporting bold logos on their sides, and all around the city people were wearing giant nametags bearing their name, face, and three things they liked to talk about. There was no mistaking it: TEDMED was in town.
For the world of health care, TEDMED was the only party at which to see and be seen. The thousand or so delegates had been specifically “curated” to encapsulate the epitome of health care innovation. For 3.5 days they basked in cutting-edge, quirky talks by people “shaping and creating the future of health and medicine,” punctuated by lavish dinners and parties, TEDMED-themed M&Ms, and morning runs, as sanctioned by the Cookie Monster (one of the celebrity speakers at this extravaganza). Meanwhile, the rest of the medical world followed the #TEDMED hashtag on Twitter or soaked up the inspiration in real time at one of TEDMED’s mostly academic simulcast venues around the U.S.
And as for me? I threw myself into getting invited to the cool kids’ party. Or to be more accurate, the cool, privileged kids’ party. Because as well as being accepted on merit, attending TEDMED in person costs an eye-watering $4,950. A wealth of sponsors paid for 200 people to attend on scholarships (and for the Simulcasts), but by the time I’d realized this and persuaded them of my innovative brilliance, they’d already allocated their funds and I was consigned to their priority waiting list. But at the last minute, delightfully, my persistence and anticipation were rewarded with a pass for the Thursday night party and the final Friday morning session.
Continue reading “How TEDMED ‘Groupinspire’ Could Change the World”
Filed Under: TedMed
Tagged: CMS, Entreprenuership, Groupinspire, Innovation, Obama administration, TEDMED
Apr 25, 2012
What does it take to get into medical school today?
High MCAT scores. Pre-requisites galore, coupled with a stellar GPA. Research experience. Clinical experience. Volunteering.
It has become a series of check-boxes, many going through the process gripe. Worse, it’s an exercise in conformity.
Last week at TEDMED, Dr. Jacob Scott shone the spotlight on this system as a root cause of the lack of creativity among people going into medicine.
“You can’t take any risks, or you won’t get in [to medical school] – you won’t get into the club,” he told the audience. But, he continued, that means weeding out creativity. Future doctors are being trained to “memorize certainty,” rather than think imaginatively.
Having gone through the admissions process recently, I could relate to many of Dr. Scott’s sentiments. It’s true: preparing to get into medical school does little to encourage risk-taking. Admission criteria are rigid. And you know if you don’t do what they ask, there is no shortage of others who will.
Want to become a doctor? You can’t slip up, or you’ll fall behind. You can’t rock the boat, or you won’t get admitted.
This critique is not unique to medical education. Scott’s talk reminded me of a speech by former Yale English professor William Deresiewicz to the 2009 plebe class of the United States Military Academy at West Point. Skeptical of modern benchmarks of success, Deresiewicz told the young cadets:
“It’s an endless series of hoops that you have to jump through [to get into college], starting from way back… What I saw around me were great kids who had been trained to be world-class hoop jumpers. Any goal you set them, they could achieve. Any test you gave them, they could pass with flying colors…. I had no doubt that they would continue to jump through hoops and ace tests and go on to Harvard Business School, or Michigan Law School, or Johns Hopkins Medical School, or Goldman Sachs, or McKinsey consulting, or whatever. And this approach would indeed take them far in life.”
Continue reading “Is Medical School Admission Squashing Creativity?”
Filed Under: Physicians, TedMed, THCB
Tagged: Education, med school, Medical Education, TEDMED
Apr 23, 2012
Last year Priceline founder Jay Walker bought TEDMED –a conference that licenses the TED style and brand but is separately owned from its famous cousin. While there was some fun controversy about the sale, Walker made two key decisions. First he moved the conference from San Diego to Washington D.C. to try to get it more central to the health policy debate, and second he initiated a set of 50 Great Challenges from which the community voted a top 20. These are things like tackling the obesity crisis, getting transparency in medical research, training next generation of leaders and more.
Much of the fun and high production value entertainment from previous years stayed, but there was a new sense of urgency in the air concerning making changes from a top down and bottom up level in the way policy works for science and technology. There was rather less information technology than in years past and more emphasis on things like training of physicians, food policy, and basic science.
Like TED there’s a strong sense of celebrity at TEDMED with entrepreneurs like Walker and buddy AOL founder Steve Case on hand, mixing with newscaster Katie Couric and volleyball pro Gabby Reece. There’s also an interesting (and we hear not cheap) sponsorship model with the exhibit hall being more about zones for discussion rather than tradeshow demos. We like Philips sleep discussion and Booz Allen Hamilton’s discussion area.
Continue reading “TEDMED Goes to Washington”
Filed Under: TedMed, THCB
Tagged: Jay Walker, Obesity, Personalized Medicine, prevention, sleep deprivation, TEDMED
Apr 16, 2012
Over the exhilarating four days this past week, we all fell in love a little bit — with the city, the Center, the meeting, the ideas, and one another. The city was Washington, DC, a touch past its cherry-blossom blush; the meeting was, of course, TEDMED. The ideas were of about honoring our health, environment, food, and about making health and healthcare efficient and kind for all.
I fell in love with dreamers. Though their dreams were varied, their paths to fulfilling them all converged into the same stream. Like a trip down the Amazon that the biggest dreamer of all, Jay Walker, the curator and the force behind the meeting used as a metaphor for TEDMED 2012, they accepted their tortuous and demanding journeys and, much to our delight and benefit, made a stop at the Kennedy Center. And although I will only mention a few, many others will stay with and inspire me for the months to come until TEDMED 2013.
I fell in love with Bryan Stevenson, who spoke about his grandmother and identity and justice.
Continue reading “How I Fell In Love at TEDMED”
Filed Under: TedMed, THCB
Tagged: Jay Walker, TEDMED
Apr 16, 2012
Filed Under: TedMed, THCB
Tagged: Francis Collins, TEDMED
Apr 13, 2012
It’s the kind of event where you might find yourself (as I did) seated between the Surgeon General and a Nobel Prize winner in Chemistry, with a singer/actor/model type across the table. Yet somehow, everyone finds common ground.
Once again, a who’s who of people descended on San Diego for TEDMED – three days packed with smart, provocative folks discussing how Technology, Entertainment, and Design play out in the healthcare field.
We’ve been attending TEDMED for a few years now, and this one might just be the best we’ve seen yet. From my perspective – an engineer at heart who’s devoted the past twelve years to growing a healthcare technology and communications company – TEDMED boiled down to this: the challenge of managing a range of increasingly complex systems, the need for collaboration, and a clear call to action to effect change.
We’re not kidding when we talk about complexity. A few highlights: Dean Kamen (one of my former bosses and current mentors) of Deka Research & Development and David Agus of the University of Southern California made their respective calls for a more responsive regulatory environment in the face of more complex and sophisticated medical breakthroughs, as well as an approach for documenting the social cost of not approving them. Eric Schadt of Mount Sinai School of Medicine described the dizzying complexity of genetics the way an engineer might model a network – think of a GPS for your DNA – helping even those (like me) who can’t grasp the genetic system understand how it works and how personalized medicines interact with it.
Continue reading “E-mail from TEDMED”
Filed Under: THCB
Tagged: health information, health technology, Innovation, TEDMED
Nov 7, 2011
Yesterday I got a fun mass email–reprinted here at Medgadget–from Richard Saul Wurman. He founded TED, and later lost control of it to Chris Anderson who has stewarded it to being a giant among conferences. Then he founded TEDMED which ran once in the early 2000s and after Mark Hodosh approached him they restarted it together in 2009. Now I’m not one for paying $4,000 to go to a conference but luckily RWJF did it for me and I went in 2010. It’s great fun, as you might expect, but pretty elitist and (warning: rival conference organizer envy alert ahead!) I don’t think it did much to advance the conversation on the core issues of improving health (and yes I think Health 20 does…). On the other hand it’s not TEDMED’s stated intent to do that, much as the RWJF crowd wanted into. Instead it’s about showcasing advances in medicine — which we all know is in general unrelated to health.
But yesterday it got fun. Hodosh sold the company to Jay Walker (a major & very good presenter at the last TEDMED) and Saul Wurman sent an email out blasting him & Walker and telling the price–$16m with $9m more to come! So Hodosh sold out and at that price who the hell can blame him!
But why did Walker pay that much? Eyeballing the crowd TEDMED had 500-ish attendees. Assuming even 400 paid the $4K rack rate (for $1.6m) and that sponsors kicked in another $2m, we’re only talking about a $4m revenue business. 4-6 times revenues is a nice number indeed!
And Saul Wurman is critical of Walker & Hodosh for wanting to make it even more elite like Davos–and in his email he links to a NYTimes article which says that it costs $200k to get into Davos. Is there an appetite for that level of pricing in medical care? We’ll see!
I guess the smaller question is, will TEDMED sans Saul Wurman lose any credibility? His departure from TED didn’t exactly hurt it, although I’m sure Walker and Hodosh would rather it hadn’t happened this way.
My guess is that so long as the branding relationship with the main TED is rocksolid. TEDMED will be fine & I guess we’ll just have to wait to find out if Walker will sit on the stage next to Hodosh like Saul Wurman through every presentation–which I thought was the oddest part of the whole conference.
Filed Under: THCB
Apr 15, 2011