Focus

PUBLISHED ON  November 17, 2014

WRITTEN BY  Roni Zeiger

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As I gain perspective about life and work, I continue to believe that the world will be a better and richer place if more of us can work at the sweet spot between our passion and our skills. Passion means we are seeking the impact we care most about and we can sustain our effort. Skills means we are serving the area we are most equipped to impact. Two quotes which bring that home for me:

“The word priority came into the English language in the 1400s. It was singular. It meant the very first or prior thing. It stayed singular for the next five hundred years. Only in the 1900s did we pluralize the term and start talking about priorities. Illogically, we reasoned that by changing the word we could bend reality.” — Greg Mckeown in Essentialism: The Disciplined Pursuit of Less

“The way we spend our days is, of course, the way we spend our lives.” — Annie Dillard

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Flash mob meets tumor board

PUBLISHED ON  September 16, 2014

WRITTEN BY  Roni Zeiger

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I recently had the privilege of leading a “masterclass” at Stanford’s Medicine X conference. This is one of those situations where you pretend to be an expert, people tell you a bunch of awesome stuff, and then you actually become a bit of an expert. I summarized the current system: researchers invent new drugs, experts give lectures about them, front line clinicians prescribe them to their patients, who do (or don’t) take them in the context of their families and communities.

The question we brainstormed: how might we reconfigure these actors if there were no rules, no laws. Should patients invent new drugs? Should families prescribe treatments? Should communities recruit researchers to work on the problems they want solved?

A few nuggets for me:

  • patients, families, and communities seem to be much better at working as a *team* than the health care system is
  • community not as the source of answers but as a mechanism for putting potential answers in context, the role of community as translator
  • @txtngmypancreas said she might want to collaborate with an inventor, and she’d want to bring her community with her for that collaboration

Which led to this juicy idea: what if whenever doctors or other experts were discussing your case with you, you could instantly invite your community? You could predefine who you ideally want present (two relatives or two hundred community colleagues), give them as much advance notice as possible, and send out the meeting link. They all get to listen. Their questions or comments can go into a queue which a pre-assigned curator from the patient’s community prioritizes for the patient to review in real time, in case she wants to discuss them with the clinical team.

Technically, this is quite easy to build today. Should we?

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If you hear hoofbeats…

PUBLISHED ON  July 7, 2014

WRITTEN BY  Roni Zeiger

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We often say in medicine, “If you hear hoofbeats, think horses, not zebras.” Put another way, if you hear wheezing, asthma is much more likely than a roundworm infection in the lungs. Young doctors especially need to be reminded of this, because we spend a disproportionate amount of medical school learning about exotic diagnoses.

I had a rare opportunity this summer to travel to Africa. In the Serengeti National Park in Tanzania, I was amazed by zebras literally as far as my eye could see.

If you hear hoofbeats

An academic reaction is simply that the prevalence of zebras in the Serengeti means the saying about hoofbeats doesn’t apply. But there’s something transformative about being surrounded by more zebras than one can count. While it’s true that there aren’t that many zebras in the world, there are more people with rare diseases than most of us realize.

Let’s think of each other often, and collaborate to solve problems faster.