TruClinc - A telemedicine platform that is gaining acceptance with providers.

Telemedicine is finally getting off of the ground with TruClinic.

Very different from the doc-in-a-box model of other telemedicine players, TruClinic is the first truly embedded technology that closely fits how providers already work.

TruClinic has been built into a full telemedicine platform with a knack for tackling hard integrations, bottom-up user growth, and jaw-dropping uses. TruClinic’s cloud-based portal gives providders and patients access to each other from anywhere. All they need is a computing device, Internet connection, and a webcam, smart phone or tablet. From remotely wiring every home on the Goshute Reservation to facilitating interactions between a mother and her newborn child in an ICU to hosting surgical followup appointments, the uses of an always on, instantly connected telemedicine platform are only starting to be realized.

TruClinic is already being used actively by both small individual physician clinics, and larger hospital and clinic chains like the University of Utah Health Care that serves 5 surroundings states in a referral area encompassing more than 10 percent of the continental US and where TruClinc helps the U to reach their clients better, particularly in fields that mostly require communication, like mental health or post-surgery follow-up.

The University of Utah Health Care System is a thought leader in telemedicine. Here's a video:

You can request a demo of TruClinic here.

One of the places that this is likely to be addopted first by individual physicians is around concierge or cosmetic medicine, where a very high-touch interaction at a distance can really have an effect on an ability to scale and interact with more patients in the same amount of time.

Theranos - It’s now worth more than $9 billion, and poised to change health care.

I see a lot of startups that look at some form of incremental increase. Theranos is looking to remake the diagnostic and blood testing industry entirely.

Theranos is a story worth learning about: Could there be one of the first real moves towards always-on diagnosis technology that really drives preventive medicine forward?

Holmes had then just spent the summer working in a lab at the Genome Institute in Singapore, a post she had been able to fill thanks to having learned Mandarin in her spare hours as a Houston teenager. Upon returning to Palo Alto, she showed Robertson a patent application she had just written. As a freshman, Holmes had taken Robertson’s seminar on advanced drug-delivery devices–things like patches, pills, and even a contact-lens-like film that secreted glaucoma medication–but now she had invented one the likes of which Robertson had never conceived. It was a wearable patch that, in addition to administering a drug, would monitor variables in the patient’s blood to see if the therapy was having the desired effect, and adjust the dosage accordingly.

“I remember her saying, ‘And we could put a cellphone chip on it, and it could telemeter out to the doctor or the patient what was going on,’ ” Robertson recounts. “And I kind of kicked myself. I’d consulted in this area for 30 years, but I’d never said, here we make all these gizmos that measure, and all these systems that deliver, but I never brought the two together.”

To Blog or Not to Blog?

Victoria Dunckley, MD first started blogging on her own website to share information with patients and parents. When she moved her integrative psychiatry practice and opened a new office in Los Angeles, the blog helped her grow the practice. The blog also brought in consultation work with patients from all over the country, and has led to expert witness work, as well.

The posts on her blog eventually evolved into ideas for a book. When I first met Dr. Dunckley and began working with her, I suggested she pitch a blog column to Psychology Today as a way to increase her reach and national impact and meet her goal of "increasing awareness about the ill effects of screen-time."

It would also help make her book proposal for her book, Reboot Your Child's Brain, more attractive to agents and publishers. She did so and the result is her Mental Wealth Column on PsychologyToday.com.

At first, she blogged tangentially about her book topic with posts on topics such as misdiagnosed bipolar disorder,  how electronic screens can contribute to tics and 10 rules for safer cell phone use, so as not to give away all the information in her upcoming book. However, over time, she began to blog more specifically about electronic screens and their effects on children's brains and mental health--including what she has termed "electronic screen syndrome."

Indeed, her high profile blog posts contributed to landing a top agent and a book deal with New World Library for Reboot Your Child's Brain. Even before that book comes out, though, her blog has already helped her have a powerful impact. Dr. Dunckley reports, "I've received emails from people all over the world telling me how a particular article has helped them. Those emails make all the effort worth it! Blogging has also helped sharpen my writing skills and has led to supportive connections with like-minded individuals."

So, should you be blogging? Here are some reasons to blog and a few reasons not to:

Reasons to blog:

1. Blogging can help you reach a large group of people with your ideas and make an impact.

2. Blogging can help hone your writing skills.

3. By inviting comments you can find out more about how your audience/readers think and what they want to read about.

4. Comments and other responses to your blog can help you clarify your own ideas, explore new avenues or see things differently.

5. Your blog can attract a large audience of fans who are then interested in buying your books, attending your seminars or hiring you as a consultant.

6. Your blog can attract media attention: more and more the media are finding experts for radio and TV shows through searching the web. Your blog helps them find you as search engines like Google love CONTENT and your blog is full of relevant content.

7. Your blog can attract patients or clients to your medical practice or business. Again, search engines like Google are looking for websites with lots of relevant content. Websites with extensive blogs and tagged with appropriate "keywords" win out on Google.

8. Publishers LOVE authors who blog, especially if you are reaching a large audience.

9. Blog posts can be short--less time cnosuming than writing a magazine article, for instance.

10. Blogging is a great way to be viewed as a thought leader--and rightly so.

So, why wouldn't you blog?

a. Blogging takes some time. You will need to figure out where that time will come from and schedule it in for blogging to work.

b. You don't get paid. Sure, some people have ads on their blogs, but that can detract. In general, you don't get paid directly for blogging.

c. You may need to learn a few new skills--beyond writing, you'll need to learn wordpress and get some sense of how search engines work so you can make your posts "discoverable" on search engines like Google.

d. You'll want to blog with some consistency or it's harder to develop a consistent following of readers.

I hope none of these reasons deter you. Basic blogging skills can be learned in a day and the benefits are many--to your medical practice, your business and your own personal satisfaction.

If you want to learn more about blogging and other forms of reaching the public with your medical knowledge, join me at Harvard Medical School's CME course on writing and publishing: Achieving Healthcare Leadership and Outcomes through Writing and Publishing March 31-April 2 atthe Fairmont Copley Hotel in Boston, MA.

There, doctors who are also bloggers and published authors, as well as agents, acquisitions editors and other experts in the publishing industry, will guide you in the many writing opportunities available to doctors and others in the health professions. You'll also have many opportunities to share your ideas with us one-on-one and receive guidance for navigating this exciting arena.

Doctor, Should You Be Writing?

There was a time when a handful of doctors wrote books. Now, many doctors' books have graced the New York Times Bestseller list. And there are even more opportunities for doctors to write and reach an extraordinary number of people--through blogging, publishing online articles, or writing newsletters--to name a few.

Doctors decide to write for various reasons--from the desire to reach more people with the valuable health information they have to offer to supporting an entrepreneurial venture to the joy of tapping into their creativity. I've known a doctor who increased funding for his medical research, others who segued into a speaking or consulting career (actually, he did that, too!) and still others who saw the writing as more of a satisfying creative outlet.

As Harvard Medical School's CME publishing course is coming up in just over a month, it's the perfect time for a doctor to explore the itch--or dream--to write. The official title of the course is Achieving Healthcare Leadership and Outcomes through Writing and Publishing.

Here are a few takeaways and tips from past graduates of Harvard Medical School's CME writing and publishing course:

From Donna Hicks, PhD, author of Dignity: "Only write about something that you know. You cannot fake authenticity and authenticity is what sells."

Hicks' book Dignity: Its Essential Role in Resolving Conflict was published by Yale University Press and Hicks reports, "Publishing Dignity has changed my life. Becoming an author catapulted my credibility exponentially. Three years after publishing my book and I am in just as much demand as the first year. I love giving talks about a topic that I feel so passionate about. You can't shut me up!"

Martha Rhodes attended the Harvard course two years ago and her book 3,000 Pulses Later: A Memoir of Surviving Depression without Medication was featured in the New York Times, Psychology Today online and many other publications. The book's publication has led to paid speaking engagements where she has the opportunity to reach more people with her message. Her biggest takeaway:

"Understand who your audience is – visualize the exact, specific person you want to read your book and why you want them to read it. And the biggest takeaway? — Just proceed!"

And Leslie Shapiro's attendance led to writing Understanding OCD: Skills to Control the Conscience and Outsmart Obsessive Compulsive Disorder which is being published by Praeger Publishing. She suggests anyone considering writing a book to ask yourself, "If you don't write it, who will?"

You don't need to be contemplating a book to attend. You can find out more about writing articles, blogs and more at the course as well.

The course will be offered March 31 - April 2 at the Fairmont Copley Hotel in Boston, MA and includes sessions on understanding the publishing industry, narrative writing in healing, how to write a memoir, writing a book proposal, publishing choices, how to write compelling prose, using social media and more.

Click here for more information on Achieving Healthcare Leadership and Outcomes through Writing and Publishing.

It's Not Possible To Be Fully Human If You Are Being Surveilled 24/7

Groklaw has now shut down it's operations to avoid exposing all of it's email to government surveillance.

Groklaw is a site that provided deep analysis of the legal system, providing explanations of ongoing court cases. Now it's joined other online services like Lavabit that have closed down in order to protect their users privacy.

You can read the entire story here but the following I found especially compelling:

...What I do know is it's not possible to be fully human if you are being surveilled 24/7.

Harvard's Berkman Center had an online class on cybersecurity and internet privacy some years ago, and the resources of the class are still online. It was about how to enhance privacy in an online world, speaking of quaint, with titles of articles like, "Is Big Brother Listening?"

And how.

You'll find all the laws in the US related to privacy and surveillance there. Not that anyone seems to follow any laws that get in their way these days. Or if they find they need a law to make conduct lawful, they just write a new law or reinterpret an old one and keep on going. That's not the rule of law as I understood the term.

Anyway, one resource was excerpts from a book by Janna Malamud Smith,"Private Matters: In Defense of the Personal Life", and I encourage you to read it. I encourage the President and the NSA to read it too. I know. They aren't listening to me. Not that way, anyhow. But it's important, because the point of the book is that privacy is vital to being human, which is why one of the worst punishments there is is total surveillance:

One way of beginning to understand privacy is by looking at what happens to people in extreme situations where it is absent. Recalling his time in Auschwitz, Primo Levi observed that "solitude in a Camp is more precious and rare than bread." Solitude is one state of privacy, and even amidst the overwhelming death, starvation, and horror of the camps, Levi knew he missed it.... Levi spent much of his life finding words for his camp experience. How, he wonders aloud in Survival in Auschwitz, do you describe "the demolition of a man," an offense for which "our language lacks words."...

One function of privacy is to provide a safe space away from terror or other assaultive experiences. When you remove a person's ability to sequester herself, or intimate information about herself, you make her extremely vulnerable....

The totalitarian state watches everyone, but keeps its own plans secret. Privacy is seen as dangerous because it enhances resistance. Constantly spying and then confronting people with what are often petty transgressions is a way of maintaining social control and unnerving and disempowering opposition....

And even when one shakes real pursuers, it is often hard to rid oneself of the feeling of being watched -- which is why surveillance is an extremely powerful way to control people. The mind's tendency to still feel observed when alone... can be inhibiting. ... Feeling watched, but not knowing for sure, nor knowing if, when, or how the hostile surveyor may strike, people often become fearful, constricted, and distracted.

I've quoted from that book before, back when the CNET reporters' emails were read by HP. We thought that was awful. And it was. HP ended up giving them money to try to make it up to them. Little did we know.

Ms. Smith continues:

Safe privacy is an important component of autonomy, freedom, and thus psychological well-being, in any society that values individuals. ... Summed up briefly, a statement of "how not to dehumanize people" might read: Don't terrorize or humiliate. Don't starve, freeze, exhaust. Don't demean or impose degrading submission. Don't force separation from loved ones. Don't make demands in an incomprehensible language. Don't refuse to listen closely. Don't destroy privacy. Terrorists of all sorts destroy privacy both by corrupting it into secrecy and by using hostile surveillance to undo its useful sanctuary.

But if we describe a standard for treating people humanely, why does stripping privacy violate it? And what is privacy? In his landmark book, Privacy and Freemom, Alan Westin names four states of privacy: solitude, anonymity, reserve, and intimacy. The reasons for valuing privacy become more apparent as we explore these states....

The essence of solitude, and all privacy, is a sense of choice and control. You control who watches or learns about you. You choose to leave and return. ...

Intimacy is a private state because in it people relax their public front either physically or emotionally or, occasionally, both. They tell personal stories, exchange looks, or touch privately. They may ignore each other without offending. They may have sex. They may speak frankly using words they would not use in front of others, expressing ideas and feelings -- positive or negative -- that are unacceptable in public. (I don't think I ever got over his death. She seems unable to stop lying to her mother. He looks flabby in those running shorts. I feel horny. In spite of everything, I still long to see them. I am so angry at you I could scream. That joke is disgusting, but it's really funny.) Shielded from forced exposure, a person often feels more able to expose himself.

I hope that makes it clear why I can't continue. There is now no shield from forced exposure. Nothing in that parenthetical thought list is terrorism-related, but no one can feel protected enough from forced exposure any more to say anything the least bit like that to anyone in an email, particularly from the US out or to the US in, but really anywhere. You don't expect a stranger to read your private communications to a friend. And once you know they can, what is there to say? Constricted and distracted. That's it exactly. That's how I feel.

The Shadowy Price Fixing World Of The AMA & RUC

Want to know how the AMA controls prices for healt care in the US?

The RUC (of the AMA) meets in secret to divvy up roughly $85 billion in U.S. taxpayer money every year. And that’s just the start of it. Because of the way the system is set up, the values the RUC comes up with wind up shaping the very structure of the U.S. health care sector, creating the perverse financial incentives that dictate how U.S. doctors behave, and affecting the annual expenditure of nearly one-fifth of the United State's GDP.

From this article from Washington Monthly

While these doctors always discuss the “value” of each procedure in terms of the amount of time, work, and overhead required of them to perform it, the implication of that “value” is not lost on anyone in the room: they are, essentially, haggling over what their own salaries should be. “No one ever says the word ‘price,’ ” a doctor on the committee told me after the April meeting. “But yeah, everyone knows we’re talking about money.”

That doctor spoke to me on condition of anonymity in part because all the committee members, as well as more than a hundred or so of their advisers and consultants, are required before each meeting to sign what was described to me as a “draconian” nondisclosure agreement. They are not allowed to talk about the specifics of what is discussed, and they are not allowed to remove any of the literature handed out behind those double doors. Neither the minutes nor the surveys they use to arrive at their decisions are ever published, and the meetings, which last about five days each time, are always closed to both the public and the press. After that meeting in April, there was not so much as a single headline, not in any major newspaper, not even on the wonkiest of the TV shows, announcing that it had taken place at all.

In a free market society, there’s a name for this kind of thing—for when a roomful of professionals from the same trade meet behind closed doors to agree on how much their services should be worth. It’s called price-fixing. And in any other industry, it’s illegal—grounds for a federal investigation into antitrust abuse, at the least.

Via this post on Medical Spa MD

Publishing Beyond Your Wildest Dreams: An Interview with Carrie Barron, MD

As we near the date of Harvard Medical School’s CME Publishing Course (March 14 – 16), I’m excited about seeing colleagues again and even meeting some of my current clients whom I have not yet met in person. I recommend the course to almost anyone writing a book about health or well being—it’s a fabulous place to meet agents and publishers—and to learn so much about the publishing industry in a short period of time.

Authors get feedback about their book ideas—and often end up with a much better sense of both what their  book is (what I call the book concept) and what they need to do to become successfully published.

Today, I’ve interviewed Carrie Barron, MD—co-author with her husband Alton of The Creativity Cure, which was published by Scribner and came out in hardcover last Spring. I met Carrie at the Harvard course a couple years ago and began working with her on her book concept and book proposal. Here's

her story.

Lisa: Why did you want to write a book?

Carrie: I spent many years scribbling thoughts and ideas on pads and blank documents and wanted to organize them into something. I was fascinated by creativity all my life--read about it, researched it, lived it as a former singer. In my private practice as a psychiatrist I was struck by how people’s moods and feeling about living could dramatically improve if they were involved in a creative process.

Lisa: Were there specific goals that motivated you? Opportunities you hoped the book would open up?

Carrie: I wanted the opportunity to write because I enjoy it so much.   Writing is a way to explore, to understand, to gain perspective and even to heal. Also, I felt that this information could be helpful to people who were trying to find ways to feel better--less depressed, less anxious--and not having any luck. Creativity has been called “the original anti-depressant.”

Lisa: When we met at Harvard Medical School’s CME Publishing Course you’d mentioned that you’d been playing with the ideas for a book you were calling, “I’m Creative But I Can’t Create.” Can you say more about where you were with the book when we met?

Carrie: Before Harvard Medical School’s publishing course I had many, many pages but no organization.  I had titles, essays, ideas, inspiration but not a coherent package. I didn’t know how to write a proposal. I didn’t have an outline.

Lisa: What did you want to accomplish by attending the Harvard course?

Carrie: I wanted to turn an idea into a product, to have an effective method of writing- meaning a free, letting go part and a structured, crafting part and to learn how to balance them.  I wanted to have a writing life and to be able to maintain it. I also wanted to learn about the whole world of writing and publishing because while writing it self is joyful, getting it out there is a completely different thing.

Lisa: What did you get out of the course at Harvard?

Carrie: I learned an enormous amount about writing from the editors and writers themselves.  I realized the importance of promotion and social media and how to integrate this into the process in a way that feels organic. I met editors and agents with a wealth of useful information. I met many people with interesting ideas. The most surprising things I learned were that I could handle “pitching,” that the idea does not have to be perfect and that collaboration with the right person can make all the difference. I met you, Lisa, and Jeanne Fredericks, who became my literary agent. You helped me clarify my book concept and craft my book proposal and Jeanne became our agent—and negotiated a six figure book contract with Scribner. It has been thrilling to work with the Scribner team.

Lisa: Any exciting opportunities that have come out of being a published author?

Carrie: So many things!  We signed with Scribner.  We have had about thirty- five appearances including talk radio, panels, lectures and presentations. We’ve have contributed to articles published in The Atlantic Monthly, Parade Magazine and others, have a regular blog on Psychology Today, spoke at The Maker Faire, the Zoomer Conference in Toronto, on the Dr. Alvin Jones radio show and recently participated on a panel on Creativity and Mental Health at the Cactus Café at UT Austin. The talks are exciting—people ask  fascinating questions that really make us think.  Other writing opportunities have arisen.

Lisa: Like?

Carrie: We’ll be collaborating on some interesting projects that will focus on using Your Own Two Hands and the value of True Connections to other people. The paperback is coming out in the summer. Frankly, I realized all my goals and beyond.

Lisa: Anything you’d like to say to someone who’s considering attending Harvard Medical School’s CME publishing course March 14-16 in Cambridge, MA?

Carrie: This course changed the entire course of my career. It was fun, informative and stimulating from start to finish. If any doctor has dreamed of writing, the HMS course is the place to go.  And don’t forget to sign up for the pitch fest because it is the best preparation for what’s to come!