Notes from Neil

I am sure this happens to you too.  You are at a party and a friend introduces you to others you are meeting for the first time.  At some point, they ask 'So what do you  do?'

'So what do you do?'    

When someone asks this question, we often start talking about work and our professional activities. Some may avoid 'talking about work' and go on to talk about what they do with their family.  However, what I learned from Bob Rosen, author of the  New York Times bestselling book Grounded is that both the question and answer are misplaced.

Who you are is not defined by what you do.  For example, my position as president of MHRI or as an academic cardiologist is not who I am.  These are things I do (with passion!) because of who I am.  The things I choose to do (and the manner in which I do it) is a product of who I am.  Yes, the truth is that what you do is driven by who you are and not the other way around.

So who are you? That is what the person at the party meeting you for the first time really wants to know.  

What we learned at our  MHRI Managers' retreat today is that  who you are (the roots of the tree), the part of  you that makes up the components of 'you' (that make you grounded) and allow you to grow (the tree to grow) and become what you have become are based on different domains of health.  These domains include: physical health, emotional health, intellectual health, social health, vocational health and spiritual health. Think about it - if you  don't have physical health, your ability to 'do things' will be impaired.  Same for emotional health and all the others. Knowing yourself in each of these domains helps you become grounded and working on improving these different healths makes your roots stronger so your 'tree' can grow stronger and weather the winds of change. 

These concepts will form the bases for the professional development program called 'MedStar Leader of the Future.'  Over the next few months, I hope to share more information on my perspective on each health domain and the launch of MedStar Leader of the Future program.

• Men’s health
• Women’s health
• Primary and preventive care
• Heart and vascular care
• Orthopaedics and sports medicine
• Rehabilitation (physical, occupational, and speech therapy)
• Same-day surgery
• Full-service medical imaging
• Laboratory services
• Other specialty services

Once again, the new year is full of predictions. In the Wall Street Journal's Saturday Essay, Eric Topol (a cardiologist by the way!) shares his vision of how smartphones will change medicine.  Two things struck me:  1) 'Wow' - this is really going to change everything we currently do today and how the emphasis will move to 'health' (early detection and prevention of disease) that is driven by people rather than doctors and 2) a sense of Déjà vu - you see, it was this time last year that I posted on this blog about SmartPhone Medicine.

Nonetheless, this article is very provocative.  Here are a few excerpts:

Over the past decade, smartphones have radically changed many aspects of our everyday lives, from banking to shopping to entertainment. Medicine is next. 

With the smartphone revolution, an increasingly powerful new set of tools—from attachments that can diagnose an ear infection or track heart rhythms to an app that can monitor mental health—can reduce our use of doctors, cut costs, speed up the pace of care and give more power to patients.

Let’s say you have a rash that you need examined. Today, you can snap a picture of it with your smartphone and download an app to process the image. Within minutes, a dedicated computer algorithm can text you your diagnosis. That message could include next steps, such as recommending a topical ointment or a visit to a dermatologist for further assessment.

Even bigger changes are in the works. Using wearable wireless sensors, you can use your smartphone to generate your own medical data, including measuring your blood-oxygen and glucose levels, blood pressure and heart rhythm. And if you’re worried that your child may have an ear infection, a smartphone attachment will let you perform an easy eardrum exam that can rapidly diagnose the problem without a trip to the pediatrician. 

Even bigger changes are in the works. Using wearable wireless sensors, you can use your smartphone to generate your own medical data, including measuring your blood-oxygen and glucose levels, blood pressure and heart rhythm.

Other wearable sensor tools now being developed include necklaces that can monitor your heart function and check the amount of fluid in your lungs, contact lenses that can track your glucose levels or your eye pressure (to help manage glaucoma), and head bands that can capture your brain waves. Someday, socks and shoes might analyze the human gait to, for instance, tell a Parkinson’s patient whether his or her medications are working or tell a caregiver whether an elderly family member is unsteady and at risk of falling.

Take asthma attacks. A teenager who’s prone to wheezing in gym class could get comprehensive data on environmental exposures such as air quality and pollen count, along with data on physical activity, oxygen concentration in the blood, vital signs and chest motion; their lung function can be assessed through their smartphone microphone, and their nitric-oxide levels can be sampled via their breath. Then that information could be combined with the data from every other tracked asthma patient—and trigger a warning, delivered by text or voice message on the teenager’s phone, that an attack is imminent and tell the teenager which inhaler would prevent it.

As I said, very thought provoking!

So let me guess...your new year's resolution this year involved healthier living. Whether through exercise or diet, or what you will or will not do this year as compared to last - right?

Since we all spend a substantial amount of time at work, I ask you to start the year by thinking about healthier living while at work. This fits nicely with our HRO (high reliability organization) goal to have a safer environment for us, our associates and our patients. It also fits nicely with our goal to improve wellness (such as healthy choices through benefit selection and the wellness committee activities). 

Let me tell you about one of my initiatives - through our new relationship with 1776 I learned about a healthier desk that helps get you up and moving! The body is just not made to be in a sitting position for a prolonged period so this "treadmill desk" allows you to stand and slowly walk (0.5 to 2.0 MPH) as you work.  We placed one of these in the cardiovascular core laboratory to try it out.  In the attached pictures, you can see me reading echocardiograms (cardiac ultrasounds) and filling out the electronic case report form, as part of a multi-center trail on new heart valves.  

It's great!  This afternoon, I walked 7000 steps (3.5 miles based on my fitbit) as I got my work done!

So what will make your workplace safer and healthier?  Discuss this with your supervisor and management team. We want to hear your ideas.  I am committed to our MHRI associates to make this as healthy a work environment as possible and will look at any reasonable idea that is feasible. Remember, improving health, including our health, is part of our overall vision of "advancing health" at MedStar so lets start the new year out on the right foot!