Category: Uncategorized

Nominate a Speaker For TEDMED

Feb 6, 2016

By JOHN IRVINE

Neeti writes:

I am on the 2016 TEDMED speaker review committee/research scholar i.e. I am among the group of people who will be reviewing potential speakers for this year’s event.

If you know someone (does not have to be an MD or PhD) who is doing great work in medicine, public health and policy or education (any aspect of healthcare including basic science research) and would be interested in giving such a talk, please nominate them here. It is a short form which needs their bio and pitch for a talk, also a speaking sample in public domain (i.e. YouTube or Vimeo) if available but not a necessity.

A little background about their nomination process: “There is no deadline to nominate a speaker, and we accept nominations year-round. Typically, we consider about 10,000 nominations for about ~50 spots on our stage, and are nearly done with the speaker selection process for this year. However, if we receive your nomination after we have completed the selection process, we will keep it in our database for future years.”

Biden’s Moon Shot and the 21st Century Cures Bill

Feb 6, 2016• 2

By STEVE FINDLAY

Screen Shot 2016-02-06 at 12.33.50 PM

Lawmakers in Washington are gearing up to pass major, far-reaching legislation on drug approval and cancer research. This is a good thing in the main but—no surprise here—Republicans and Democrats differ on approach and details, and things are already getting messy.

This makes the proposed legislation very risky. It could all implode in an election year, but momentum is building fast and both parties have something to gain by passage.

This blog is a primer on what’s happening. Future posts will track the legislation’s progress and delve into some of the issues at stake. Comments are invited.

The Secrets of Cancer Survivors

Feb 6, 2016• 5

By JAMES SALWITZ, MD

Disclaimer: I have never had cancer. Therefore, at the most basic level, I do not have the right to pontificate about dealing with the dread disease.

Rather, I have been the servant and support of those that struggle with cancer. I thought it might be of some assistance to share my observations from the other side of the bed rail. Perhaps, their secrets of survival may help you.

1. Cancer is a team sport; do not do this alone. Never show up to an important appointment by yourself. You are dealing with a physical impairment, as well as a complex mental challenge, at the same time that you are frightened and do not feel well. Have someone with you to listen, ask, take notes and simply carry your things. This is true not only during treatment, but at home. Accept support. Build a team. Work together to fight this awful thing.

2. In the same way, whether you like it or not, a family goes through this together. Those that love you, also “get cancer.” Working together helps everyone deal with the affects of the disease. You are not a burden. You reap what you sow.

3. Nonetheless, it is also important to get time for yourself. You need grounding time; quiet moments to heal. Take a deep breath; rebuild. If your family does not understand the importance of “me time,” show them this note.

4. Be on time for your appointments, tests and treatments. This is my own hang-up, but being on time is part of being organized and I have noted that the patients that are punctual are organized and those that are organized do better.

5. Be whiney. Really, complain a lot. Tell your doctors what is happening. Take notes. Email. Call. Will the doctor give you his cell number? Do not ignore a fever for five days, crawl into the doctor’s office, and say, “By the way, I feel terrible.” That will result in the doctor saying, “By the way, time to go to the hospital.” This is why women make better patients then men; malignant macho.

David Vivero, Amino– Yes, We Need Another Doctor Search Company!

Feb 5, 2016• 1

By MATTHEW HOLT

Those of you dismayed at the dearth of recent interviews of notable health tech startups on THCB will be glad to hear I have several in the can and will be putting them up starting with Amino today. And the rest of you can move along….

David Vivero made his money at a company matching renters to apartments that ended up part of Zillow. That was too easy, so now he’s decided to match people up with the right doctor. Amino came out of stealth late last year with about $20m in funding and it has acquired large data sets (including being one of the few with official access to all CMS physician data) and some complex ways to match patients to doctors–the primary one being doctors near you that have seen a lot of patients like you. Why are they in a market that already has several well known & well funded players like Vitals, Healthgrades, Better Doctor and more? David told me that and more in this interview.

Physician Burnout is an Epidemic

Feb 5, 2016• 4

By ANEES CHAGPAR, MD

There is a disease sweeping the nation that has significant consequences for every person living in this country, even if they never contract it directly. And despite its lethality, there is precious little being done about it. It’s called physician burnout, and it affects all of us.

Doctors, on average, spend at least eight years in college, followed by years of postgraduate training during which time they work 80 hours a week. They graduate with a mountain of debt, face the constant fear of malpractice litigation, and are burdened by incessant demands to see more patients in less time with more administrative paperwork. On top of which, there’s compassion fatigue – helping the sick, the injured and the dying is rewarding no doubt, but often emotionally draining. All of this leads to physician burnout.

More than any other profession, doctors face burnout, and the rates have been increasing. A recent study by researchers at the Mayo Clinic found that the number of physicians suffering from burnout is 54%, up from 45% in 2011. And physicians are more than twice as likely to commit suicide than non-physicians; every year, 400 doctors in this country take their own lives.

Why should you care? Because the emotional health of doctors has a direct effect on the broader public. There are a plethora of stories of physicians who describe the chilling consequences of their depression. One surgeon wrote in a recent blog, “my depression…was exacerbated by work. I clearly wasn’t performing to the best of my abilities, and my patient complications and complaints were increasing. A patient died from a post-operative bleed. Would I have managed it better if I wasn’t suffering myself? (When I spoke to the patient’s wife, as he lay dying 20 feet away, she asked me if I was OK.)” Burnout causes a lack of clarity in thinking leading to medical mistakes. “Given the extensive evidence that burnout among physicians has effects on quality of care, patient satisfaction, turnover, and patient safety, these findings have important implications for society at large,” researchers from Mayo Clinic told Forbes.

The Search for the Elusive Elixir of Life

Feb 4, 2016• 17

By TOM EMERICK

flying cadeucii Here’s the executive summary: Most disease and health spending is age-related. As we age we get infirmities ranging from dementia to cancer to vascular disease. Nothing can prevent aging. Period. For millennia mankind has been been on a futile search to prevent aging.

Search for the Elusive Elixir of Life

For 3500 or more years mankind has been searching for the mythological Elixir of Life, the fountain of youth, the philosophers stone, pool of nectar, etc, that will defeat aging and extend life, if not achieve immortality.

According to Wiki, “The elixir of life, also known as the elixir of immortality and sometimes equated with the philosopher’s stone, is a mythical potion that, when drunk from a certain cup at a certain time, supposedly grants the drinker eternal life and/or eternal youth.”

All around the globe from 400 BCE alchemists, from India to China to Europe, were seeking the elixir of life. Many thought gold was an essential ingredient of such an elixir.

The Fountain of Youth, also known as the water of life, was part of the search for the elixir of life. That search was in full throttle during the crusades, and was carried to the New World by Spanish explorers, the most famous of whom was Ponce De Leon in the 1500’s. Even the Mayans had legends about waters of eternal youth.

Gawande, Frankl, and Why “Less Is More” Is More of the Same

Feb 3, 2016• 4

By MICHEL ACCAD, MD

Screen Shot 2016-02-04 at 8.03.58 PM

My last post was prompted by a reader’s comment where Victor Frankl’s Man’s Search for Meaning and Atul Gawande’s Being Mortal were juxtaposed. Since receiving that message, I have had occasion to notice that others also associate these two books.

For example, both are mentioned positively in this moving article by Dr. Clare Luz about a friend’s suicide, and in these tweets from Dr. Paddy Barrett’s podcast program:

Friends and patients of mine have likewise mentioned these two works to me, expressing praise and testifying to the deep impact the books have had on them.

I suspect that many readers of this blog will at least be familiar with these two books. If not, summaries are here (Frankl) and here (Gawande).

Short-selling Private Practice

Feb 3, 2016• 1

By KAREN SIBERT, MD

Today is a remarkable day for me. I’m officially leaving private practice after almost 18 years, to return to academic medicine with a faculty position in a highly regarded California department of anesthesiology.

Why would I do that?

There are many positive reasons. I believe in the teaching mission of academic medicine: to train the anesthesiologists of the future, and the scientists who will advance medical care. I enjoy teaching. The years I’ve spent at the head of the operating room table, anesthetizing patients every day, have given me a great deal of hands-on experience (and at least some wisdom) that I’m happy to pass along to the next generation.

But the other, more pragmatic reason is this. I’ve lost confidence in the ability of private-practice anesthesiology in California to survive in its prevalent form — physician-only, personally provided anesthesiology care.

MD-only: A viable model?

California is an outlier among all other states in its ratio of physicians to non-physicians in the practice of clinical anesthesia. Nationally, there are slightly more non-physicians — including nurse anesthetists (about 47,000) and anesthesiologist assistants (about 1,700) — than physician anesthesiologists (about 46,000) in the workforce, according to 2015 National Provider Identifier (NPI) data.

Don’t like CB Insights’ numbers? Just wait…

Feb 3, 2016

By MATTHEW HOLT

Last year I got in a modest Twitter spat with Anand Sanwal the CEO of investor analytics company CB Insights. Anand writes a very amusing newsletter, has built a wildly successful business tracking venture investing (at $20-50K a client) and has recently taken on $10m in VC himself to build out his business which was already profitable. The spat was because in August 2015 (5 months ago) CB insights said that “Digital Health” investments totalled $3.5 billion in 2014. You can go read the article Stephanie Baum concocted from the Tweetstream but my point was that when CB Insights, a generalist analyst company, said that the investment in ~~digital~~ SMAC health was $3.5bn in 2014 they were wrong because 4 specialists (Health 2.0, Mercom, Rock Health and Startup Health) all said it was over $4.5bn.

What’s a billion between friends? Not much, but what I left unsaid until now is that if they’re 25% off the average in one sector, where are they in the other sectors they cover? But other than a few amused readers of MedCity News no one much cared and the world moved on.

Then everyone stared putting out their Q4 2015 numbers. Amusingly, but probably only to me, both Rock Health & Startup Health put out their Q4 numbers 2 weeks before the quarter/year ended, and missed a bunch of late deals! But by the time the revised numbers came in everyone was again in that middle $4 billion range and there was general agreement that funding was about flat in 2015 compared to 2014–albeit at a high level compared to what the Cinderella sector had been recently.
Health 2.0’s numbers in our report were $4.8 billion for the year, as shown on the left. (You can see more on these and some other data in our Q4 report here. In case you don’t know I co-run Health 2.0 as my day job and yes I own THCB). OK. All so far so ho-hum.

Then as the other numbers started coming out I noticed something a little odd. CB insights came out with its numbers for 2015, but something was different.
You’ll recall that I had poo-poohed their 2014 number shown as $3.477 Bn in their blog post here and displayed in the chart below. These are 2014 numbers shown in a post about investment in 2015, published in August 2015. CB Insights chart with 2014 $$ in Aug 15 And that was the number I’d started the original spat about. But when I looked at the post they released in January 2016, not only was the number for 2015 at $5.7 billion (remember Rock Health, Mercom & Health 2.0 all put it in the mid-high $4s) but the 2014 number had somehow climbed from about $3.5 billion to $5.1 billion. CB Insights chart with 2014 $$ in jan 16 Again check the January post and check the chart I’ve lifted from it below. You’d think this was a curious jump and you’d be right. But nowhere in the post does it say why the total for 2014 in August 2015 was so different from the total for 2014 in January 2016.

Of course being the troublemaker I am, I asked about this on Twitter and got a classic no reply from Anand at CB insights. sanwal
So then I sent all this info off to Stephanie Baum at Medcity News thinking that she might like to write more about it.

And a funny thing happened. Instead of writing the article I wanted her to write (i.e. this one!) She found yet another number for 2015 from CB Insights, and wrote about how they were now back in the pack with everyone else.

Should Your Employer Have the Right to Track Your Weight?

Feb 1, 2016• 3

By AL LEWIS and VIK KHANNA

Suppose there were: (1) a widely held but false perception that gays had lower productivity and higher healthcare costs than straights; (2) false literature that companies with gay conversion programs outperformed the stock market; and (3) a mandate that companies disclose to shareholders the percentage of gays they employ.

Obviously, many corporate CEOs would stop hiring gays, de facto require gay conversion among current employees, and fire gays who failed the program, in order to maximize stock price and hence their own net worth.

Preposterous? Of course, but if Johnson & Johnson (J&J), Vitality Group and a few pharmaceutical companies get their way, this exact same scenario will befall overweight employees. Indeed, two-thirds of this dystopian scenario is already in place: