Finding a Cure for Cancer

May 19th, 2010 by pcahn

Malcolm Gladwell has become a favorite management guru for his pithy accounts of how innovation happens. His New Yorker pieces and bestselling books synthesize the latest social science research into counterintuitive narratives.

In Outliers, he debunked the idea that genius is inbred. In Blink he suggested that snap judgments often have more accuracy than reasoned evaluation.

In a recent New Yorker issue devoted to innovation, Gladwell analyzes oncology research. His descriptions of lab science belie the image of the triumphant PI pursuing a clear vision. Often, the biggest breakthroughs come from the least planned experiments. Moreover, the most effective treatments are cobbled together approaches, not a single, miraculous drug.

His account emphasizes the need to allow serendipity in research as well as humility.

Planning for Retirement

May 18th, 2010 by pcahn

Few topics can kill a conversation like retirement planning. For as dull as the topic is, spending some time early in a career thinking about it can pay large dividends in the long run.

Boston University offers two retirement programs for employees. In the first plan, which kicks in after two years of service, the university makes a contribution to your retirement account based on your salary. The second plan, which you can start anytime, allows employees to defer up to $16,5000 a year into a supplemental account. This money is pre-tax, so at the same time it lowers your overall compensation for tax purposes.

For the supplemental plan (also known as a 403b), BU employees can choose from a suite of funds managed by TIAA-CREF or Fidelity. Both have solid reputations and low fees, but Fidelity offers more investment options. Of course, for some people, having fewer choices is a good thing.

Both TIAA-CREF and Fidelity send reps to the medical campus each month for free consultations. It's worth making an appointment every few years or so to make sure you're on track to meet your retirement goals.

Mentoring in the Aftermath

May 17th, 2010 by pcahn

It has been several months since the news of Amy Bishop's attack on her colleagues at the University of Alabama, Huntsville made national news. Although Bishop's New England roots have kept the story in the Boston press, it wasn't until I read an article in a recent issue of Nature that I learned how her department is coping with the loss of key faculty.

When you see the portraits of her murdered colleagues, it becomes clear that the UAH biology faculty included several minority scientists. In turn, they mentored many minority graduate students, who were left without advisers. Retired faculty and area industry leaders have stepped in to help shepherd the doctoral students, but the loss reveals how much effort a mentor must expend to develop a cadre of future faculty.

The second insight from the Nature report is what happened to the deceased PI's grants. Government funding goes to the institution, not the faculty member, so the department was able to have surviving members take over existing grants. The NSF and NIH also gave extensions on all the grants except for Bishop's own.

BMC Gala

May 13th, 2010 by pcahn

Over the weekend I attended the Boston Medical Center gala. In many ways, it was a typical fundraising dinner. A local newscaster emceed, the mayor of Boston spoke, and we ate wan chicken entrees.

What made the event memorable and even emotional, though, was a video montage of patient stories. Screens throughout the hall showed three BMC patients with complicated illnesses and how their doctors helped them overcome problems. Then, the lights went back on and the patients came on stage to a standing ovation.

As moved as I was by the skill and compassion of the BMC physicians, I couldn't help but notice that all the cases involved surgeons. Certainly, removing a tumor provides dramatic before and after images, but what about the medical interventions? Where are the heroes of the Department of Medicine who demonstrate BMC's mission of "exceptional care without exception?"

Medical School Enrollment

May 12th, 2010 by pcahn

In 2006, the Association of American Medical Colleges set a goal of increasing medical student enrollment by 30% to roughly 21,000 in 2015.

At first it seemed like economic trends were pushing in the opposite direction. Inside HigherEd reported that several publicly-financed medical schools were reducing enrollments or contemplating closing altogether. The only increase in numbers came from the opening of new medical schools.

Now, an AAMC survey projects that U.S. medical schools will reach their target of 30% increased enrollment by 2018. And almost all of the 125 schools accredited in 2002 have expanded their student bodies.

Mother’s Day

May 10th, 2010 by pcahn

In honor of yesterday's holiday, let me highlight resources for parents in the Department of Medicine.

The Department sponsors backup childcare when gaps in regular care arise. It costs $15 an hour with a four-hour minimum. The care givers are available day or evening, weekdays or weekends.

I have to admit that finding out information about maternity leaves at BU is confusing. The website for the Associate Provost for Faculty Development lists a draft policy that is still under debate. The Faculty Handbook offers its own policy.

There's a whole different policy that governs physicians covered by BMC's Faculty Practice Plan. While it may be impractical to have a single policy covering all faculty, it would make it easier to centralize the information.

Orientation

May 6th, 2010 by pcahn

The Department of Medicine hosts its second orientation for new faculty today. It's a compressed format: just an hour of formal presentations followed by half an hour of small group discussions. When it's over, the entire faculty will join in a reception to welcome the new members.

When I became an assistant professor my home institution sponsored a semester-long orientation for new faculty. Some of the content was helpful, some of it I could have figured out on my own, and some was a waste of time.

Reflecting on the experience, I realize that the most important resources I took from the sessions were the relationships with colleagues. Once we scattered to our respective departments, it was rare to see faculty from other disciplines. The cohort I spent that fall semester with became mentors, confidants, and friends.

Doctor-Patient Interactions

May 5th, 2010 by pcahn

On the second day of Dan O'Connell's visit, he addressed a lunchtime group of clinicians on how to communicate more effectively with patients. Although I am not a medical doctor, I took away some key points that can make interactions with any client go more smoothly.

He emphasized that the doctor and staff must work as a team. The worst thing a doctor can say upon meeting a patient is, "What brings you in today?" The patient has already shared his or her concerns with the medical assistant and usually the referring physician, so an opening statement like that signals that the group is not working together.

A little preparation--even a five minute huddle with staff before clinic--can go a long way in smoothing out the day. This is advice that translates to many settings.

Difficult Conversations

May 4th, 2010 by pcahn

This week we've been hosting Dr. Dan O'Connell, a clinical psychologist and expert in health care communication. At a lunchtime seminar, he addressed how to talk to disruptive colleagues.

One of the take away points for me was that the person is not the problem, the problem is the problem. Rather than telling someone, "You are incompetent." It is more helpful to say, "I noticed that the patients were not put in rooms today. Did you notice that too?" This approach enlists the person in crafting a solution. Criticism only puts the other person in a defensive posture.

To the Point

April 30th, 2010 by pcahn

It's become so commonplace to give presentations with PowerPoint that delivering a talk without one grabs notice. But does the software enhance oral communication?

Edward Tufte, a professor emeritus of Political Science, Statistics, and Computer Science at Yale, has written extensively about the limitations of PowerPoint. In one famous example, he takes on NASA's reliance on PowerPoint. When it comes to studying the Challenger tragedy, a hierarchy of bullet points seems inadequate for the task.

PowerPoint slides work best, I feel, when they illustrate a point. Images, graphs, and maps enhance the speaker's argument. But simply putting the talk on the screen in a usually arbitrary format insults the audience and detracts from the talk.