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NY Times covers Oncotalk

As an oncology fellow, I had the previledge of attending an NCI sponsored research conference on communication skills for oncology fellows titled: Oncotalk in Nov. 05.  It was recently covered in the New York Times.

See link: NY Times article.

on to oncology

it's been a while since I wrote on this blog.  It's been a busy month.  After finishing the boards, I started my month of Oncology service.  my senior colleagues had told us that there is a very steep learning curve, and they were right.  It's amazing how much I have learned in just one month.  I know that this year will be very busy, but my goal is to continue to chip away at the project (prostate cancer review) during this year.  

As part of my fellowship, I also am required to do research, and what I want to do is: be involved in various research projects to learn the basics of the reseach, and bring that to the group here.

I think many people have visited and joined the group in the last month, as always, I encourage everyone to put in their views out in the open, don't be shy.  I understand that many people may be hesitant and think "what will others think of me," <I know i did, it took me some time before coming up with the concrete idea and running with it>.  But as I have learned, when I floated the idea around, I did "meet" all of you who have similar interests. 

Please keep an eye out on our SAHRI Journal  for new projects and ongoing projects. 

Again, share your expertise and knowledge. 

Biren

Off till Aug 24th

My Internal Medicine boards are in three weeks, and I am going to take some time off and study for them.  You can still reach me via email, but I think the number of posts from will (I hope) decrease substantially.

Biren

Interacting with other organizations

I ran into Dr. Rajaram, a Pulm/CC attending at RWJ and Princeton.  Someone I had known from my residency.  She and her husband, Dr. Kandasamy are affiliated with International Medical Health Organization, a humanitarian charity.  I didn't get time to tell her much about SAHRI and the interactions we might have because of time, but I thought about it as I was going thruogh their website.  And these thought apply to many other organizations that exist which are focused mainly on humanitarian aid.

Few observations (again, many organizations like this one exist).

1.  Many of the members have health care background (physicians, nurses etc.)

2.  All of them have the drive to do help others in need

3.  Most help by giving their time and monies.

So, what is the interaction with SAHRI:

- SAHRI focuses on long term issues: changing health care and health management by encouraging relevant medical research...

- These organizations can be the community arms that help us translate the research

- these organizations can help us with the research in health behavior (one of the feedbacks I received is that it is hard to get south asians to participate in research projects).

- many of the organizations' volunteers have the medical background and expertise that can be leveraged to improve the research (recruiting patients, developing research questions, gaining better understanding of disease processes obtained from the experts in the community).

- collaborate with other similar organizations and improve their funding, obtain efficiencies in operations, better delivery of care

These are just the few reasons why organizations need to come together and all can benefit.

Biren

 

Is it all talk?

This is continuation of my conversation with Alpesh, See altruism  and changing behavior for previous discussion. 

One of the other comments Alpesh made was (and again, I thank him for his insight), "at some point in time [you] have to stop talking and start actually doing the work."  I think it is a VERY good point and goes back to the thoughts on the importance of having small successes initially to attract more resources to our cause.  I have been focused on making contacts with those resources that I think will be helpful, at the same time, working on issues thworking at are close to my own research interest - cancer screening.  I am doing that by using the wiki database - prostate cancer.

But as I do the review, I realized that while wiki is a good input format, we will need better output format ---  output is still an issue, especially for the purposes of reseach and we stilll need help find additional resources.  So, I go back to making contacts and finding resources.   It is a tough balancing act.

Underlying all of this is the belief that we need to utilize the power of numbers - find those who believe in this concept and issues.   Which will also expand the work we do and how fast we do it.  As you recall, when SAHRI started, it was going to be a local project at my residency, but then I got wise and thought of the global need and resources and how to utilize the power of numbers.

Biren

Altruism

This is continuation of my conversation with Alpesh Patel, MD MBA, a cardiology fellow.  This is not on SAHRI blog because it reflects personal views.   Please see SAHRI blog for thoughts on Changing Behavior.

One of the other points Alpesh made was: how do you get others to contribute?  Do you offer monetary compensation?  Or is it left to their "good will."  It's a question that my friend Steve Shu had raised very early on in our conversations about SAHRI.  It is also a frequently asked question by "realists."  I respect the question.  I will confess --- I have a "naive" view of the world.  I think that there are people out there who want to do good work (and many of them are in medicine, because it attracts those types of people).  So yes!  I do want the initital work to be done on "good will," "altruistic nature" or whatever else you want to call it.  But I am not that naive either, I realize that you need funds--- I mean, I too have a day time (full time) job. And eventually when I feel comfortable (read: we have shown to be a viable organization with one of two successes), we will go out and do fundraising.

Will it work?  I hope so.  The way I look at it, if only 1% of the people I approach believe in what we want to do, we will be extremely successful (as Thomas Friedman cited someone from Microsoft in his book, "when you are one in million in china, you are one of 1500").  Obviously until we have gotten results and successes, it will be hard to convince masses to spend the energy and effort.  Once we have had successes, money will flow (read: "if you built it, they will come").  I believe in people--- I reallly do.  Once we show the world that we are worthy, the world will open up the wallets. Plus, I also believe in the combination of "altruism" with ingenuity and entrepreneural skills to make the organization financially stable.

So, how do I see this working in the real world?   Well, as we do the research, we will have business opportunities based on our findings (servicing the communities' needs will lend itself to entrepreneurs).   For example, it can be an information management system that helps patients manage diseases and those delivering medical care, may be even non-medical fields like restarurant business and athletic business can work to benefit from out efforts.  Those individuals/entrepreneurs who work with us, will have an opportunity to benefit from our "intelligent resources."  Of course, there are no formulas set--- who gets what, but Universities work in similar fashion. 

At least, that's the thought right now.  Of course, comments are welcome and nothing is set in stone.

Biren

Reshuffle- copy of "Biren's Blog"

This is one of the earlier entries that I have moved to my own blog.
Biren

Growing up

Today is the last day of my residency.  Tomorrow, when I go to work, I will go as a "FELLOW."  I have been reflecting on the past few years.  My wife, Neha, tells me that "when [she] first met me, I was this little medical student."  I think I know what she means .  But I think she is right.  I feel that I am growing everyday... both on a personal and a professional level. 

Professionally, when I started residency, I knew I wanted to do oncology (for many reasons... including the fact that death and dying did not bother me).  But I have learned and grown and I think I know what I want better.  I know what I want to do is: not just take care of patients and families the best I can, but also teach the principles of humanism and professionalism to the next generation of physicians. 

I have also learned a valuable lesson.  Never stop learning.  Never think that you know enough.  This applies not just to medical knowledge but also personal growth.  I have struggling between being certain and uncertain. 

Starting SAHRI has been a great experience in personal growth.  I am doing things that I never imagined.  I never saw myself as a "business" person... "doing meetings, lunches or dinners," or "making a presentation," or figuring out how to get someone's attention in less than a minute (like an elevator ride).  I never thought that I would ever be focusing on "research."  [For those non-medical personnel, most doctors usually classify themselves as either "clinicians" - taking care of patients or "researchers"-doing bench research or clinical research].  But I am doing all of that.  I am going to meet people, pitch the idea, getting feedback etc.  Things that an MBA or an entrepreneur would do. 

Please don't get me wrong, I am not complaining, just amused as I reflect on the past three years.  I am constantly learning.  I am learning about the process, sharpening my presentation skills, thinking about our vision how to make it happen.  I am thinking about how to finance the project, how to use technology to enable our projects etc.

But I am enjoying... regardless of what happens.  I hope that soon we will contact the medical students and residents across the US to let them know of our plans and ask them to join in our effort.

Biren

For Non medical professionals and collaborators

I was at a party last weekend and there were a few professionals (mostly IT, sales etc) there.  While I was trying to tell them about what we want to do... It occurred to me that I need to do a better job at explaining what are our goals and why it is important at all.  So, I figured I should try again.  (plus, every iteration of the explanation makes it better).

Why the need for SAHRI?    See our goals

In plain English.  Medical doctors try to work by using the guidelines produced based on "clinical evidence."  The evidence comes from studies.  For example, much of what we know about coronary disease in the US comes from a landmark study in Framingham, MA.  About 40 or so years ago, researchers did a thorough study of the people of Framingham and followed them (and their descendants) for years to understand what factors predicted heart disease, mortality etc. 

Someone might argue, why the need for specific population study?  Well, we know from other studies that the South Asians have higher incidence of diabetes at an earlier age.  So, clearly there is some evidence that the population is different (with different genetics and risk factors).  But that is only one aspect of one disease.  Given the fact that we are finding out more about genetics and genetic basis of diseases... population based study will improve the health of the population (about 1/5 to 1/6 of the world population).

So, How does research happen?  As I said before, you need smart people, with resources and interest.  I think we have smart people... I work with them everyday.  Resources... we can find them... interest... that is the key.  We have to develop a generation of researchers with interest in South Asians.  In general, every one in the field of medicine is encouraged to develop research interest and perform research.  Medical students, residents and fellows... from personal experience as a medical student and resident (and now a fellow starting July 1st), few thoughts:  research is time consuming (rightfully so),  and knowledge on how to perform good studies is lacking.

So, we want to fill those gaps.  We want to provide those interested with guidance and resources.
- a medical knowledge database will provide an up-to-date information on what research has been done, what is being done.
- a resource database will provide a list of key topic education, and hopefully personnel who will help them with their projects
- a list of ongoing projects that need help etc. 

Why the need for IT? 

- much of medical profession is still working on snail mail.  We need to leverage the technology to enable our organization to accomplish its goals.  We use wiki, blogging, and others that have yet to be developed.
- we need to bring the information to the doctors and the patients.  I submit that technology will make innovation easier and make practice safer.
- Research will be easier with IT in place (easier to do chart review etc.).

So, I hope this makes the project easier to understand.

Biren

   

Interesting model for our organizational management

Recently Steve had a post on Non Profit Organizations which prompted a response from Ken Thompson and his experience.  The principles he outlines in bioteams are very interesting and can provide a good model for us in the future.

The describes the concepts of working in teams when all the members are not physically attached.  He also describes some ground rules which will important for us as we move forward.

You know, it may make me sound like a geek, but actually enjoy the theoretical discussions and implementation of it.  As I have said in the past, to the best of my knowledge the principles of collaboration with the use of technology is something that is new to the medical research field. 

Biren

 

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