Panda’s Back!!

I was just doing some reading yesterday and saw that PandaBear, MD’s blog is now being archived over at SDN. I’ve stayed subscribed to his original site’s feed since he retired just in case he ever popped back in to say anything. As I wandered over to the SDN archive expecting to find a 1:1 copy of his original site, I saw that he actually started writing again on this new site back in March! This just made my day. I’ve got some serious catching up to do! If you’ve never read Panda’s blog, you can start with some things that I thought were notable. Enjoy!

Linux for Clinics

I ran across a new linux distro today that I thought was pretty cool. It’s called Linux for Clinics. It’s an Ubuntu-based linux distribution geared toward running an entire medical office. It utilizes a few project I’ve heard of before, like GNUmed, but this is pushing to be a full-fledged medical clinic OS. Development seems slow, but I’m hopeful that it continues because it could be a strong contender for clinics, especially ones with little funding. One critique I have in the development (which I of course know nothing about) is that they seem to be a vanilla Ubuntu install with a few different/altered packages. I wonder if this might be better accomplished using a Launchpad PPA as opposed to a full re-spin. It seems like this would make upkeep much more efficient between major Ubuntu releases every 6 months. I just don’t know if that’s feasible… If I have more time in the future, I may try to get involved in this.

Strange Diseases, Oh My!

We were learning about a few strange diseases in Microbiology today. Sadie loves to read books on weird diseases like the ones we were talking about. Most of them are nonfiction, and they all sound pretty bizarre. I’ll add a short list of books she has read or reviewed and their corresponding diseases.

Before you ask, yes, my girlfriend is a huge nerd when it comes to books like this :-P Practically every time we’re at borders she’s got something like this in her hand with a more “normal sounding” fiction book. I don’t think some of those books could keep my attention long enough, but if you’re interested, check them out. I stick to to her fiction recommendations!

M3 Clerkships Lottery

Rush has a “lottery” to determine what order everyone’s M3 clerkships will be in. For those who don’t know, our M3 and M4 years are entirely clinical. We’re supposed to rank them from best to worst depending on our preferences, and a computer program will crunch the numbers and determine which order each student will get. Here’s my top choices:

M3 Clerkship lottery

My picks for the M3 Clerkship lottery

You can’t see the end of my list, but I essentially put everything at the bottom where Internal Medicine and Surgery are last. I prefer to have Medicine in the first half of the year. Surgery is supposed to be the most intense, so I attempted to pad my schedule before and/or after with a break or Psych (a notoriously laid-back rotation). I doubt I’ll change it any before tomorrow. Feel free to suggest changes or let me know what you think!

Making Mistakes

Making Mistakes | iface thoughts.  This was a great realization by Mr. Nadgouda.  Making mistakes (and learning from them) is the key to true innovation in any field.  Unfortunately, mistakes are not so “affordable” in medical treatment.

What can we do to continue to advance our field without endangering the lives of patients?  Is the only way to innovate in medicine through approved research?  Or is there a place for innovating and learning from mistakes in every medical practice that will not harm our patients?  What about the efficiency of your office and its dynamics?  What about innovation in the economics of the health care industry?

It’s something to think about.  Unfortunately, I think the threat of being slapped with a lawsuit has stifled a lot of potential innovation in medicine.  There is a fear of making mistakes, and a desire to maintain the status quo.  No doubt we want to reduce the number of negative patient outcomes, but that should not be done at the expense of the future of medicine and its practice.

Taking Back The Power of Science

I read an article on Ars Technica [via /.]the other day that made me very worried about the future of scientific discovery in the US. With our currently failing economy, I don’t understand how we can still be making such idiotic decisions about the future of some of our most innovative industries.

The scientific research industry is fueled by governmentally funded programs like the NIH and NSF. As a taxpayer and citizen, I cannot believe the idiocy of some of statments against open access in Congress. There is a particularly poignant response on the /. article demonstrating how the greed of publishing companies in a dying industry are attempting to use their financial power and influence over government to squelch dissenters that oppose their bottom line. Let’s face it. With electronic distribution of written material available, the publishing industry as we know it is dying. There’s no way to stop it aside from them increasing their hold of copyrights and copyright law. There is no reason that publishing companies should be taking any sort of “ownership” of research that they publish. With the minuscule cost of publishing something online today, the publishers truly have almost no overhead to publish a scientific article. This was not the case 20 years ago when they had to print and ship their journals across the globe, but today they simply have to put it online. Their work is practically done for them by PubMed, the Google of biomedical science research. Sure, they need to find peer reviewers (one of the cornerstones of research), but do you think that publishing companies actually pay these reviewers? (No.) If that’s the case, why are they still charging thousands of dollars to researchers in order to publish an article? I think it’s because they used to have a reason to, and now that they don’t, it just means bigger profit margins. People don’t like it? They’ll pay the government to make them like it.

This article and the /. post made me start to wonder if an open access journal had already been started. A quick Google search showed me that it had: the Public Library of Science (PLoS). The PLoS is an open access journal published in the United States that guarantees that all of it’s material is available free of charge online. Not only that, but everything is released under a liberal Creative Commons Attribution license, the researchers retain their own copyright, and most importantly, the article is fully available on the day of publication. People don’t have to wait until tomorrow to learn about the discoveries of today. They can just dive right in. This is in stark contrast to the practices of current publishing conglomerates, who take over copyright and make non-subscribers wait a year or more (if at all) to access the material. Now, surely this is good for the publisher’s bottom-line, but you have to stop an ask yourself: Is this good for science?

Since most government-funded scientific research is done at large institutions with many faculty researchers, the scientists might not fully understand the problem. Their institutional affiliation gives them the ability to join together and pay the large fees for a subscription to the most popular journals. But some smaller institutions do not enjoy the luxury of being able to subscribe to anything. And even the largest institutions can’t subscribe to everything. There are simply too many journals. There are also many individuals, like students, and private researchers who wish to learn about what innovations our tax dollars are leading to and where these innovations might lead. Open access would likely generate a renewed interest in basic science and discovery, helping to fuel growth of the field. So should this even be an issue in today’s society? I mean scientists are generally trying to help us better understand the world we live in, the diseases we fight, and the things that affect us. The fact that a project has received a sliver of the ever dwindling government funding demonstrates that it’s a worthwhile project that will very likely yield extraordinary results for the world. Shouldn’t those results be available to anyone?

The PLoS has grown stronger since its inception, but it’s still generally small potatoes compared to the likes of Nature Publishing Group and even JACS. The PLoS now has separate journals in many of the biomedical sciences like biology, genetics, and medicine, and they even have a fast-track publication called PLoS ONE for those high priority articles.

So how is it that this journal, with its inherent ability to accelerate scientific discovery, has managed to stay beneath so many radars? The answer to that is two-fold. The scientific community does not currently seem to recognize both the underlying problem with current publishing companies and the innate ability of a publisher like PLoS to solve this problem once and for all. At the heart of this issue is the notoriety of publication. In order to be successful as a researcher, scientists want to be published in big name journals. Every one of them would love to have a publication in Nature or the NEJM. It’s extraordinarily competitive, and thus only the best of the best research makes it there. But scientists have lost sight of the fact that this notoriety is man-made. Nature is only as famous as it is because everyone wants to publish there. They get the best articles because of it. So if they want to break free of the hold that publishers have over their research, they need to set their own standards. If they want PLoS or any open access journal to be able to defeat the giants, or even get them to start listening, they have to remind the publishers that without their research, the publishers have no industry. Scientists do the work, and they should get to say what happens to it. In all likelihood, any attempt to dictate terms to a publisher is going to fail (at least at this point). But the scientific community needs to remember that they hold the power. They are the ones doing the research, and they are the ones volunteering to peer review. If the publishers won’t meet their demands, they need to meet their own demands. So listen up scientists: In this age of the Internet, you do not need them anymore. Take your research and your peer reviewers and make your own, new notoriety. Once they see you doing that, they’ll either follow suit or not. At that point, it won’t really matter.

But the reason that this has not happened and probably will not happen in near future is that scientists don’t see the dire need for open access because most of them are given most of the access they need. The sooner they realize that they need to demand open access to their work so that other scientists and the public can benefit from it, the better. Once they get past the encumbrance of permissions and red tape laid out by the publishers, they can get on with their life’s work in a much more open, collaborative environment. Otherwise, the publishing industry is going to keep tying researchers’ hands behind their backs, making it harder for them to exchange ideas, just so that they can continue to squeeze every possible dollar out of this industry. This is not good for the scientists, and it’s especially not good for science.