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Why I quit medicine

gautams.posterous.com

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Re: Why I quit medicine

#51

Post by devs1010 »

mattwrench wrote: post #18

This article touches on why it somewhat bothers me to see some of my smartest friends applying to med school right now. I'm sure being a doctor is a rewarding profession and the work they do is so incredibly important to their patients--but it's not particularly unique work. Medicine is the application of the already known. (Most med students are not going to be the next DeBakey.) Rather than contributing original wo…

You can make this argument about most software developers too, while they may create unique applications, they are mainly using the "already known" (existing languages, API's, etc)... You can then go on to apply this argument to nearly any other "white collar" job, accounting is "the application of the already known", etc..

White collar does not mean that you are in a research field and pushing the limits of knowledge, from what I understand it has long had an entirely different meaning. Personally, I feel that white collar / blue collar are very outdated terms. I often feel that a software developer is somewhat of a modern blue collar worker as its a creative trade and very different from a "white collar" job such as a sales or marketing job.

Re: Why I quit medicine

#52

Post by rokhayakebe »

harryf wrote: post #29
GFischer wrote: post #10

Earlier quoted context omitted.

I did some very basic research for an essay on "Healthcare in the Cloud", and yes, the regulatory side sounded very painful. Among the relevant regulations, the big ones are HIPAA and HITECH: http://en.wikipedia.org/wiki/Health_Insurance_Portability_an... http://www.hhs.gov/ocr/privacy/hipaa/administrative/enforcem... A big point that I remember was that a HIPAA breach was up to 1.5 million dollars in fines. "A maxim…

Wonder if smartphones open up some new doors here? Assuming doctor and patient both have a smartphone medical notes for a patient are shared but only available for doctors within the physical vicinity of the patient i.e. the patient's phone acts as the gateway to that data.

There is a way of looking at problems from a different angle.

Re: Why I quit medicine

#53

Post by gautamsivakumar »

larrys wrote: post #39

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 wanti…

Thanks so much for your support.

You're right about how important face-to-face interaction is. That is not going to be replaced any time soon - nor should it be. But for the purpose of handover, you still need a written summary of all the patients on a ward that people can refer to. As I mentioned in the post, it would be useful to see who wrote what about each patient - so that you know who to talk to for further information. Having a handover application won't replace the morning handover meeting or a person-person handover - but it will definitely make that process less painful, more accountable and much more efficient.

(P.S. if I was jealous of the so called riches of being an entrepreneur - I would have focussed my energies on my medical career and right now I'd be driving my A5 from work rather than sleeping on a friend's couch thousands of miles from home :) I don't think anybody who takes this path should be under any illusion. Most start-ups fail and it's not an easy path. That said, I do love a lot of what building a company involves...)

Re: Why I quit medicine

#54

Post by gautamsivakumar »

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…

Absolutely - there is a lot of regulation which you have to navigate and there are differences between different regions and nations. It's not the most start-up friendly market, but I don't believe that is a reason not to do it :)

Re: Why I quit medicine

#55

Post by gautamsivakumar »

tejaswiy wrote: post #36

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…

Respectfully, I disagree. I think there are some institutions which do it better than others - but on the whole, from a techie standpoint, healthcare IT is in the dark ages.

Re: Why I quit medicine

#56

Post by arn »

kami8845 wrote: post #48
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 quit medicine too, but not because of the lack of adequate computer interface :) If you don't mind my asking, why did you quit?

short answer: had kids, and a financially successful website. (longer answer: http://news.ycombinator.com/item?id=236308 )

Re: Why I quit medicine

#57

Post by nradov »

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…

Typical medical records software (EMR / EHR) doesn't require any advance FDA approval.

Re: Why I quit medicine

#58

Post by gautamsivakumar »

DanBC wrote: post #27

Medical notes need to have some obvious design features common to many other computer software. - locking: only one person able to change the record - auditing: keeping records of who read what, when, and where they did it - signing: any additions are cryptographically signed and timestamped - sharing: many clinicians need to be able to access the data across a wide range of hospital networks. The UK NHS spent £11bn…

Yep, true. The NHS IT project was a perfect example of how not to do it :)

Re: Why I quit medicine

#59

Post by larrys »

gautamsivakumar wrote: post #53
larrys wrote: post #39

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 wanti…

Thanks so much for your support. You're right about how important face-to-face interaction is. That is not going to be replaced any time soon - nor should it be. But for the purpose of handover, you still need a written summary of all the patients on a ward that people can refer to. As I mentioned in the post, it would be useful to see who wrote what about each patient - so that you know who to talk to for further in…

If you want you can email some links to the app and I will show my wife. Depending on her reaction I might be able to get in front of some people at her hospital system. I could probably also get the hospital magazine to review it or some PR there. No guarantees but when it's ready to review send me an email.

Re: Why I quit medicine

#60

Post by gautamsivakumar »

kyro wrote: post #13

Good on you, man. I'm in medical school currently and the emphasis on locking down patient data is one of the most frustrating things to see. I'm convinced that it's a policy that everyone knows has little benefit and yet pushes for ethical brownie points. What's to be gained from freeing up the data far, far exceeds what could potentially be lost. Even freeing up anonymized patient data seems to be met with oppositi…

Thanks very much!

Large scale analysis of (anonymous) patient information will lead to many breakthroughs. Hopefully, one day we will get there.

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