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Why I quit medicine

gautams.posterous.com

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Re: Why I quit medicine

#31

Post by idoh »

untog wrote: post #9
gamble wrote: post #2

Sounds a lot like the medical data startup I joined ten years ago. We were so, so painfully naive about the realities of medical software. Medical records are a trivial technical problem, but an almost insurmountable political and regulatory challenge. I knew our company was doomed when we were talking to another medical software company and saw the literal wall of binders that represented a single FDA approval proce…

It happens far too often. Right now I'm looking at a government RFP (request for propsals) that fits what I'm doing very well. But everyone I speak to tells me that it's an entirely doomed process, and that the government will never choose a tiny tech startup over a large corporation. I'm pretty sure they're right.

By law many federal agencies have to give research grants to small businesses. My mom runs a physics research company and that's how they stay in business.

You check out SBIR grants - http://en.wikipedia.org/wiki/Small_Business_Innovation_Resea...

Re: Why I quit medicine

#32

Post by devs1010 »

The topic of regulation that others have mentioned here makes me think of the airline industry also as, from what I can tell, medical regulations are almost as strict as those, I worked with a guy who used to do programming for devices on airliners and he said it was basically insane how much regulation there was, they were still not approved to use multi-core processors, etc so it was like programming for computers running technology of 10 years ago. I think people tend to think that healthcare would / should be much easier to use new technology for as its not quite the same as the aviation industry. However, it seems this isn't the case in legal terms and the industry may need a regulatory reform before innovation can really take place. In the case of an airliner, it really is life or death, however with healthcare, I think they can put in place enough backup systems (writing on paper, etc), even make the system do print-outs at set intervals, so if it goes down, there is a paper record right there, or something like that, so these issues can be overcome

Re: Why I quit medicine

#33

Post by philwelch »

arn wrote: post #6

I quit medicine too, but not because of the lack of adequate computer interface :) The whole taking notes, jotting down patient information. It seems antiquated, but it's really a hard problem to "fix" - if it really needs fixing. These are not medical records he's talking about, but personal notes on each patient and todos you carry around with you during your shift. Paper/pen in taking these notes is faster than co…

I wonder if this is why pen-based tablets like the Newton were so popular in medicine.

Re: Why I quit medicine

#34

Post by pavanky »

Is it just me or does anyone else think all the doctors need is a bug tracking tool ? Preferably something that can be used from a smart phone / tablet via an app ?

Re: Why I quit medicine

#36

Post by tejaswiy »

You're getting it wrong I think. I work in healthcare IT and many EMRs are getting on the mobile bandwagon and building out mobile clients that let you do this.

Additionally, hospitals require doctors to put in diagnosis / treatment notes into EMRs which is usually done by transcribing service that the doctors can call or by sitting at a computer and typing it out. Although this process is worse than doing it over a mobile client, healthcare IT is not in the dark ages as people would have you believe.

Re: Why I quit medicine

#37

Post by dalore »

devs1010 wrote: post #26
gamble wrote: post #2

Sounds a lot like the medical data startup I joined ten years ago. We were so, so painfully naive about the realities of medical software. Medical records are a trivial technical problem, but an almost insurmountable political and regulatory challenge. I knew our company was doomed when we were talking to another medical software company and saw the literal wall of binders that represented a single FDA approval proce…

Yes, and hospitals have arcane policies / IT departments, my dad is a doctor and the hospital he works at still has Internet Explorer 6 installed on all computers there and they refuse to upgrade it for fear it might break compatibility with some ancient software program they use they access through it. He wants me to create some little software program to see if he can get them to use it when the main system goes do…

Why can't you code it for chrome and have the computer have multiple browsers on it?

Re: Why I quit medicine

#38

Post by sungam »

Hi, fellow UK hospital doc so fully understand the frustrations with NHS IT. I suspect problems stem from the fact that purchasing decisions are generally made by individuals (management and senior hospital docs) other than those that use the systems (in the main junior hospital docs). The other issue is that systems are implemented to reflect the way that diseases and patients should behave but there are always edge cases that do not fit into these nice boxes. Striking a balance between free-form data input, which does not add much compared to conventional paper notes, and forcing patient data into categories and drop-down boxes is a a real challenge. The other thing that is often forgotten is the amount of clinician effort required for a system. If it takes too long or is too complicated accurate data will simply not be entered in the absence of draconian sanctions from above. Anyway there is clearly plenty of room for improvement so I wish you the best of luck!

Re: Why I quit medicine

#39

Post by larrys »

With a title of "Why I quit medicine" you would think somebody quit medicine because there is something wrong with medicine or the job of being a doctor.

What we have instead is a very well intentioned individual that is getting out of medicine because they want to run a startup. And that's fine. Maybe getting jealous because they see it as a path to riches and have been reading about to many outliers. Or maybe wanting to change the world.

But the job that he does is known as a "hospitalist" in this country. (Essentially Internal Medicine but not office practice).

http://www.hospitalmedicine.org/

My wife is one, and practices in a very modern hospital system. I've asked her many times about "the handoff (signout)" from the first time we were dating. Because it seemed outdated to me that when we were at dinner (and she was on call) she had to scribble down notes about sometimes 20 patients over the phone). But apparently the verbal interaction is important as well between two doctors and can't easily be summarized in writing. And I've overheard plenty of handoffs and can attest to the interactions between doctors and the nuance that can't be expressed in writing. (I even said why can't the other doctor just record something that you can listen to and a million other ideas and she shot all of them down very easily as not being practical. And she had every reason to support an idea like that if she thought it would make me money..)

Getting things done is difficult, and yes, they are very closed minded and it's hard to get change.

But drawing a comparison with "Considering I can talk to my smartphone and tell it to send a message to my dad or remind me to water the plants when I get home" doesn't take into account that whatever system is setup and accessed needs to be rock solid, dependable and can't fail in many degrees above your typical startup offering.

So this is a great ambitious idea that he has undertaken and I wish him well. But my guess is that he will have to partner with a health system in order to get adoption of this idea and work out the kinks and prove the concept.

Re: Why I quit medicine

#40

Post by mhurron »

devs1010 wrote: post #26
gamble wrote: post #2

Sounds a lot like the medical data startup I joined ten years ago. We were so, so painfully naive about the realities of medical software. Medical records are a trivial technical problem, but an almost insurmountable political and regulatory challenge. I knew our company was doomed when we were talking to another medical software company and saw the literal wall of binders that represented a single FDA approval proce…

Yes, and hospitals have arcane policies / IT departments, my dad is a doctor and the hospital he works at still has Internet Explorer 6 installed on all computers there and they refuse to upgrade it for fear it might break compatibility with some ancient software program they use they access through it. He wants me to create some little software program to see if he can get them to use it when the main system goes do…

>they refuse to upgrade it for fear it might break compatibility with some ancient software

It will break, in horrible and unknown ways, and even if it didn't if the company supporting it got wind that you used a different version of IE, or heaven forbid Firefox, that's probably enough to deny support. It's probably not even ancient software, they might have purchased it in the last couple of years. Medical software has to be the absolute worst made software on the planet.

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