Flash mob meets tumor board

PUBLISHED ON  September 16, 2014

WRITTEN BY  Roni Zeiger

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  • Roni Zeiger Amazing to meet all these new friends in Nairobi and see the work in the field. Als… ,
  • Roni Zeiger2 of my last 3 Uber drivers work at health startups...,
  • Roni Zeiger"You build enough trust in a group & sometimes you can turn fear into joy" - in documentary. Power of community!,
  • Roni Zeiger Thank you, Charlie, for being a gracious teacher.,

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?

crowd raising hands

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.

When you get to a fork in the road, stay there

PUBLISHED ON  May 5, 2014

WRITTEN BY  Roni Zeiger

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Career advice often includes mention of forks in the road or intersections that represent key decision points. Our future depends on which way we go, which job we choose, which school. I’m starting to think it’s exactly the opposite.

When you get to a fork in the road, stay there

All the exciting things in my career have happened precisely at those intersections. Maybe better advice is to hurry up along the road you’re on until you get to an interesting intersection, then stay right there. I first thought I’d live at the intersection of molecular biology and medicine, initially planning to do an MD-PhD in order to solve the mysteries of cancer in a lab. I then changed course to pursue full time clinical medicine… until I saw how much impact I could have at the intersection of medicine and computer science. My focus here was first on building software for doctors until I learned what was happening at the intersection of the suddenly ubiquitous Google search box and the unmet health information needs of millions of people.

I worked at Google until I started seeing that so many of the complex questions people have about their health aren’t well answered in a document yet — but those same questions are often discussed in online communities, where a network of microexperts often provides useful feedback. So now, building Smart Patients, I sit at the intersection of stories and science.

Innovation seems to happen at intersections of ideas or fields that haven’t really been mixed together before. At what intersection are you uniquely suited to innovate?