An animated look at Open Science

Perhaps you’ve heard of the Open Science Movement — the belief that all scientific research should be broadly distributed online, for free. What’s behind it?  Proponents argue the cost of medical journals and papers makes acquiring knowledge way too difficult, and that firewalls are considerable barriers to scientific collaboration.

Hear more from TEDMED 2012 speaker Jonathan Eisen, who has collaborated with Nick Shockey of the Right to Research Coalition on a short animated video.

The Patient Promise: Healers pledge to lead by example

“Physician, heal thyself. And also, get at least 30 minutes of moderate exercise per day, eat nutritious whole foods, and ease some of your stress.”

That’s not quite how the biblical quote reads.  But Johns Hopkins medical students Shiv Gaglani and David Gatz are hoping doctors and nurses will heed those words nevertheless. They’ve begun an initiative called The Patient Promise that urges current and future healthcare professionals to pledge that they’ll adopt “healthy lifestyle behaviors” – physical activity, balanced nutrition, and stress management — to benefit themselves and, by extension, their patients.

Shiv Gaglani and David Gatz

The two came up with the idea after watching, with dismay, their own health decline due to the stress and long working hours of their first year of medical school. They also noted studies showing that some 63 percent of male physicians and 55 percent of female nurses are overweight or obese, what the health industry calls “tight white coat syndrome.”

That could spell trouble for patients; a study in the January issue of the journal Obesity showed that overweight or obese physicians talked to obese patients about weight management for only 18 percent of available opportunities; in doctors with a healthy BMI, that number rose to 30 percent — still plenty of room for improvement, though. Conversely, other studies show that doctors with healthier habits are more likely to counsel their patients to adopt preventive lifestyle behaviors.

Another Patient Promise goal is to combat weight bias discrimination. “Research suggests that medical students are more likely to view the obese and smokers as lazy or apathetic, which can show up in how they care for such patients down the road,” says Gaglani, who adds that he has witnessed such behavior in clinical settings.

Those pledging the Promise agree to, instead, “…identify and guard myself from potential prejudices against my patient based on unhealthy behaviors, recognizing the often complex origins of these habits.”

Since the program launched in June, 642 medical professionals and students from 50 institutions around the country have made the pledge. Participants monitor themselves, but Gaglani says he’s received a great deal of positive feedback, and that a number of students who’ve signed the promise have since lost weight or quit smoking — including himself.

“Personally, it affects my daily habits as well as my interactions with patients,” he says. “I had gained about 10 pounds during my first year of med school and have since lost those after committing to the Promise. I also have tried learning more about nutrition – something not emphasized at most medical schools – so that I can optimize my own, and my patients’, diet.

“It’s kept me honest with my own lifestyle,” he says.


What makes a doctor-patient partnership flourish?

Both doctors and patients are seeing the value of well-informed patients. See below: As part of a video series filmed by Fenton at TEDMED 2012, Lisa Witter interviews James Merlino, Chief Experience Officer at the Cleveland Clinic, and Dave deBronkart, a patient activist, on why effective treatment starts with a solid doctor-patient partnership.

Yet, no one has trained either group on how to go about furthering that goal, and doctors have increasingly less time in which to counsel patients. How can we move forward? Improving Medical Communication is one of TEDMED’s Great Challenges in health and medicine. To learn more and discuss further, visit the Challenges website.

What does it take to get people to adopt healthy behaviors?

It’s the $8,402 question — health care expenditures per person in 2010, according to the Kaiser Family Foundation — Is it possible to positively influence personal health behaviors through environment, technology and monetary incentives?

As part of a video series filmed by Fenton at TEDMED 2012 and co-produced by Fenton and TEDMED, Lisa Witter talks with Scott Ratzan, Vice President of Global Health at Johnson & Johnson, and Michael Roizen, Chief Wellness Officer of the Cleveland Clinic, about what kinds of wellness programs work best to promote wellness and disease prevention.

Have ideas of your own? To discuss inventing wellness programs that work with leaders in the health and medicine community, visit TEDMED’s Great Challenges website.

Health’s Great Challenges are hot topics this week

At TEDMED 2012, conference Delegates and TEDMED Live attendees voted to choose the top 20 Great Challenges, the most pressing, pervasive and complex issues the nation is grappling with in health and medicine. They chose well, apparently. Conversation on many of the Challenges — the goal of the program — was lively both among the TEDMED community at at large, including features on blogs and in major news media.

David Mayer, MD, vice president of Quality and Safety for MedStar Health, wrote about Challenge #5, Eliminating Medical Errors, on his blog, “as this is a problem that persists despite the hard work of many of us who have dedicated our careers trying to prevent,” he writes. Educating students and residents is critical to reducing error, he says, not only to hit the ground running with good training, but in offering fresh perspectives on the issue. A contributor, Kare Anderson, made waves with the piece, How Hospitals Can Stop Killing So Many Patients. Medical errors are the third leading cause of death in the country, she cites, and suggests that patients demand accountability and transparency, and then do as much comparison shopping as possible before selecting a hospital. We’ve heard it before: We spend more time shopping for a television than for a doctor, even though the stakes are, of course, incalculably higher.

End-of-life Care, Challenge #3, garnered much attention thanks to an op-ed by Bill Keller in The New York Times, “How to Die.” Keller wrote about an in-hospital hospice protocol in the U.K. that offer an alternative to the sometimes invasive and painful, and often fruitless measures, that accompany our last days here in the U.S. End-of-life care is a huge cost issue, Keller writes:

“….a quarter or more of Medicare costs are incurred in the last year of life, which suggests that we are squandering a fortune to buy a few weeks or months of a life spent hooked to machinery and consumed by fear and discomfort.”

Yet we should approach dying with dignity more out of concerts for the patient and his or her family, he says — a kinder way of death — than out of fiscal prudence, which will ultimately make palliative care more popular and culturally acceptable for the American public as well. On a brighter note, TEDMED’s new consulting clinical editor Pritpal Tamber, M.D., director of Optimising Clinical Knowledge — which helps organizations implement established clinical know-how — wrote on his blog wrote about what’s needed on all fronts to manage these daunting hurdles we face:  an inspiration immersion, leading to a badly needed healthcare reinvention.  Welcome, Pritpal!

The challenge of child obesity — for adults

About one in five kids in the U.S. is obese, which carries not only current health problems but a greater risk of issues like diabetes and heart disease later in life. Early intervention is key, particularly as kids are less set in their ways than adults, so it’s easier to change their behaviors and teach them new concepts.

Yet children don’t have the power over their lives, decisions, and lifestyles that adults have (parents and adults make many decisions for them and have the power to enforce certain behaviors).

Social institutions have more impact on kids than on adults (like church, YMCA, and especially school — including school lunch programs, mandatory gym classes, possible nutritional education, etc.).

Given all the factors, what’s the best way to go about reducing childhood obesity?  Who  should lead the charge? Have you seen strategies that work, first-hand?

Clearly, this is a complex issue that needs collective wisdom to address. Join the discussion about childhood obesity and ask questions to health leaders on the issue at the new interactive website,

Note to parents: The Strategies to Overcome and Prevent (STOP) Obesity Alliance and Alliance for a Healthier Generation recently released “Weigh In: Talking to Your Children About Weight and Health,” a research-based online guide that helps prepare parents for tough conversations about weight and health with their kids. View the guide at

Can we head off the dementia tsunami?

By 2050 there will be some 25 million Alzheimer’s patients, adding to the burden of care of our aging population, and bringing a colossal personal, medical and economic impact.

Jeffrey Cummings of the Cleveland Clinic Lou Ruvo Center for Brain Health, Richard Payne of the Duke Divinity School, and Gregory Petsko of Brandeis University sat down with Lisa Witter of Fenton to talk over the issue, one of TEDMED’s Great Challenges in health and medicine. Where is the science on Alzheimer’s?  Are there ways to prevent it?  And how can we better prepare caregivers?

What do you think we should be doing now to prep for what Cummings calls  “the unacceptable future?”  Share your thoughts on the interactive Great Challenges web site.

Share your thoughts: How can we better manage end-of-life care?

Modern medicine has extended the life expectancies of many terminally ill Americans. In turn, prolonging lives can mean incurring more intensive care and the associated costs.

In 2010, Medicare paid $55 billion for doctor and hospital bills during the last two months of patients’ lives. Quality end-of-life care requires balancing the input of doctors, families and patients themselves. And making crucial end-of-life decisions can take physical and emotional tolls on patients and their loved ones.

How should we help people manage end-of-life care choices to maximize individual well-being and minimize social cost? Ask experts and join our interactive conversation now on how to manage this Great Challenge in health and medicine.