29th Annual Medical Communications Conference

The 29th Annual Medical Communications Conference is about to occur in Santa Ana Pueblo, New Mexico. The conference is presented by the AMA and this year, the National Association of Medical Communicator (NAMC) members have voted and the board members moved to officially nominate Dr. Sanjay Gupta for the first annual Health Communications Achievement Award. I've never attended this conference that started back in 1980, but I hope to some day.

David Blumenthal, MD, MPP as National Coordinatior for Health IT

According to the Associated Press, the HHS announced that David Blumenthal, MD, MPP, will serve as national coordinator for health information technology (health IT). He has done a considerable amount of research on health IT issues so I'm eager to see how he will direct the future of health IT in this country. Congratulations to Dr. Blumenthal!Health IT is a growing industry and there are many opportunities for clinicians in this space.

Another Physician Compensation Survey

According to the American Medical Group Association (AMGA) 2008 Medical Group Compensation and Financial Survey, physician pay went up in 2007 by roughly 3.5%. According to this report, medical specialties that experienced the lowest increases included allergy medicine, endocrinology, pulmonary medicine and emergency medicine. With Medicare reimbursement decreasing and managed care organizations trying to push pay-for-performance (P4P) and other initiatives, physician payment is all over the map for various specialties. The survey was conducted among 44,000 health care providers, 2,700 medical groups, and 116 specialties in the United States.

Pharmaceutical Executive

There are many types of publications for executives working in the pharmaceutical industry. One magazine/journal is simply titled, "Pharmaceutical Executive" and is published by Advanstar Communications. Care to take a look at it? Using Nxtbook Media technology (e-publishing/digital publishing), they have published the March issue here:

http://www.nxtbook.com/nxtbooks/advanstar/pe_200903/

Take a look and see what's happening in the pharmaceutical industry. There are many corporate changes occurring. Jobs are responsibilities are evolving and companies are trying to adapt to all this change.

Healthcare IT Jobs

Healthcare IT News is published in partnership with HIMSS. Although I'm not looking for a new job, I like to glance at the job posts and see what's going on the health IT sector. Currently, many of the advertised job opportunities appear to be for health IT consultants who have extensive experience and expertise in the EMR/EHR space. People are looking for integration consultants, clinical documentation consultants, clinical systems analysts, and more. Expect to travel if you get hired as a consultant. Some of the job descriptions indicate "ability to travel 100%." Sounds like fun if you're single, but not if you have a family.

Happy Saint Patrick's Day Today!

Happy Saint Patrick's Day Today! I'm wearing green. Are you?

Master of Science in Medical Informatics at Northwestern University

The Master of Science in Medical Informatics at Northwestern University is offered in partnership with the Feinberg School of Medicine, Northwestern University. This program is offered online and seems like it's a terrific program. When I was applying to colleges, I applied to Northwestern as my 2nd choice college. Since I got accepted to MIT, I went to Boston. But sometimes I wonder how my life would have turned out if I had gone to Chicago instead of Boston. I suppose I'll never know. Speaking of MIT, they actually offer a program in biomedical informatics through the Harvard-MIT Division of Health Sciences and Technology (HST). If I could go back to MIT to study, I think I'd be torn between the biomedical informatics program and an MBA program at the Sloan School of Management. Maybe someday they will develop a joint curriculum that will be a joint MBA/MS for people who have a strong interest in business and biomedical informatics.

Careers in medical informatics are very broad and include areas like: health care administration; management; consulting; health IT; public health; research; academia; and much more.

American Board of Quality Assurance and Utilization Review Physicians

How do you pronounce ABQAURP? It stands for the American Board of Quality Assurance and Utilization Review Physicians. They offer Health Care Quality and Management (HCQM) Certification through an online study course and then a certification exam. Once certified, you can hang a certificate that says, "Diplomate of the American Board of Quality Assurance and Utilization Review Physicians, Inc." The ABQAURP is the only Health Care Quality and Management organization with an exam developed, administered, and evaluated through the National Board of Medical Examiners (NBME). So, you may want to learn more if you have an interest in working in quality improvement, utilization management, managed care, risk management, case management and workers' compensation. 

Rivaroxaban to be Reviewed by the FDA Panel on March 19

March 19 is match day for 4th year medical students. It's also the day when the FDA Panel is supposed to review the anticoagulant rivaroxaban (also known as BAY 59-7939 or Xarelto). It is an oral, direct Factor Xa inhibitor (I don't think I'll ever forget that coagulation cascade diagram that I learned in medical school). If approved, this drug could shut down all those coumadin (warfarin) clinics out there that monitor blood INR in people taking this vitamin K antagonist. Rivaroxaban would not require any blood monitoring. Plus, all those home INR tests manufacturers would need to look for something new to do.

I think everyone is wondering how the FDA will react to this new medication. If approved by the FDA, rivaroxaban will be sold in the US for short-term use as a prophylactic anticoagulant for patients undergoing knee- and hip-replacement surgeries. I'm sure the drug manufacturers will go for additional indications later on. Rivaroxaban is manufactured by Bayer and will be marketed by Ortho-McNeil Pharmaceutical which is a Johnson & Johnson group.

Walmart to Sell Digital Health Records

You've probably heard that Walmart is getting into the e-health record space by selling eClinicalWorks. This Electronic Health Record (EHR or EMR) is a CCHIT Certified system (for 2008) and includes a suite of several different options. According to the NY Times, this move by Walmart is to target small physician offices. Speaking of Walmart, have you noticed that they've gotten rid of the hyphen between Wal and Mart? Now they're just Walmart. Anyways, the bigger question remains: will more and more physicians embrace EMRs just because it's available from Walmart of Sam's Club? Plus, what about all those people who hate Dell computers? (I'm not one of them, but I seem to meet them all the time. Some people really have strong opinions about specific PC manufacturers. Maybe that will change with the new Dell Adamo.) With only 17% of the physicians using EHRs, there is a huge marketplace to sell and offer EHRs to those who may lack those strong computer skills. Once BestBuy gets involved in this competition, you'll start seeing a lot more of those "Geek Squad" vehicles around. If you're looking to break into the Health IT industry, maybe you should get a job at Walmart selling EHR solutions and acting as an EHR consultant. I'm sure that eClinicalWorks is bolstering their support staff and preparing for all those phone calls.

Opportunities in Medical Writing

A student recently asked me if you had to be a physician to be a medical writer. The answer is no. Opportunities in medical writing are vast. If you want to write and be a lifelong writer, then you can excel in this field as a nurse, a PhD, a PharmD, an MD/DO, or even an MS in biomedical writing. Some medical writers also do really well with a BS or BA in scientific journalism or biology. You'll have more opportunities if you have an advanced degree, but it's not a requirement to be an excellent writer.

Keep in mind that many clinicians may start out writing, but then they advance into other senior positions that may involve project planning, team management, company strategy, new business development, etc. Others love to write and that's their passion, so they have no ambition to do anything else.

2009 Match Day is Approaching

March 19 is the magical day for graduating medical students.They get to open a sealed envelope in front of their classmates and announce where they will be going for their post-graduate residency. It's quite an exciting day, generally filled with tears (of joys for some and sadness for others). It's ultimately the day when career paths are determined (unless you decide to switch specialties or transition into a non-clinical career path). For most of the students, the match is determined by an automated computer system that takes your rankings and then compares that to the way various residency programs ranked you. Couples have the option of doing a couples match, and this alters the algorithm a bit to try and match both of you in a similar geographic location. Some specialties work outside of the match. And, for those students who don't end up matching, the week before match day ends up being quite the scramble as they try to get into unfilled positions. Want to learn more? Check out the National Resident Matching Program (NRMP).

Medical Informatics Programs in the United States

Clinicians who have a strong interest in learning more about medical informatics (or health informatics) should probably invest the time and money to get formal education in this topic. There are many different ways of getting this education. You can do a fellowship in medical informatics. You can also pursue a master's program. If you're looking for a list of educational programs, take a look at the AMIA list. You can also take a look at this University of North Carolina site, although it may be a bit outdated. There are also a number of online programs where you can receive an MS in medical, biomedical, or health informatics. If you can be disciplined to study independently, then you may find that an online program is the most flexible way to receive more education.

Managed Care Terminology

If you're looking for a glossary of managed care terminology, take a look at this simple site:
http://aspe.hhs.gov/Progsys/forum/mcobib.htm

Here, you can decipher acronyms such as: DRG, EQRO, EPO, FFS, IPA, PRO, PCCM, PHP, POS, QMB, TEFRA, and more. The US Department of Health and Human Services (HHS) also has some additional resources about managed care that may be very helpful if you're interested in a career as a medical or pharmacy director in a health plan.

Merck, Schering-Plough, and now J&J/Centocor

The Merck/Schering-Plough merger/reverse acquisition may hit some problems according to some because of J&J/Centocor and the co-marketing of Remicade (infliximab). Golimumab is a similar biologic agent that is currently in development. It is supposed to be co-marketed with Schering-Plough, but I guess we're not sure what's going to happen if Merck and Schering-Plough join forces. All these pharma merges/acquisitions are starting to get pretty crazy. Some are forecasting that thousands of jobs may get cut, but no one seems to be sure where those cuts may occur. I guess we'll just have to wait and see what happens here. These are some incredibly dramatic times in the pharma industry.

Merck to Acquire Schering-Plough

It looks like Merck will be acquiring Schering-Plough in a $41.1 billion deal. But wait, it's a bit confusing. People are referring to this as a "reverse merger" and Merck's top executive, Chairman and CEO Richard Clarke, will lead the combined company, but Schering-Plough will be the surviving public corporation. The new company will be called Merck.

Handbook of Medical Informatics

A frequent question that comes up is: "What is medical informatics?" There are all types of explanations to that question, so let me refer you to an e-book that can be found here:
Handbook of Medical Informatics

There are many different types of opportunities in health or medical informatics. If you're serious about learning more, I encourage you to join the American Medical Informatics Association (AMIA) found here: http://www.amia.org/

The American Health Information Management Association (AHIMA) is also an excellent resource found here: http://www.ahima.org/

Employment Opportunities

This may not be the best time to be transitioning from a clinical to a non-clinical career. Even under this new administration, unemployment rates are climbing very rapidly. Within pharma, we see layoff announcements left and right. Pharma is also struggling because the FDA is being so overly cautious to approve new drugs. So, if you currently have a stable clinical job, you may want to wait for the economy improves to look for new opportunities.

Perhaps the only exception is within the health IT industry. I seem to see more job posts in that sector than any other right now. There is a growing need for better electronic health records (EHRs), computerized physician order entry (CPOE) systems, and the integration with personal health records (PHRs) like Google Health and Microsoft Health Vault. I've been speaking with recent college grads who have told me that they are not having problems finding jobs in the health information technology/information space. Hospitals are recognizing the need for more efficient systems and as hardware and software capabilities improve, it's important to do periodic updates to stay current and to ensure the maximum levels of data integrity and security.

Dr. Sanjay Gupta - Won't be the Next Surgeon General

Dr. Sanjay Gupta is the chief medical correspondent on CNN. He had been approached for the position of the US Surgeon General. However, he recently announced that he will not be pursuing this position and he will focus his time on neurosurgery and on his family. I'm sure he finds his current lifestyle fun and exciting - he gets to practice surgery at Emory and he travels the world to report for CNN. He has done an excellent job blending the clinical and non-clinical worlds.

The current Acting Surgeon General is Rear Admiral Steven K. Galson, M.D., M.P.H. and the Acting Deputy Surgeon General is Rear Admiral Robert C. Williams, P.E., DEE. John Maynard Woodworth (1871-1879) was the first Supervising Surgeon of the Marine Hospital Service.

Residency or Research?

I got a note today from a medical student who asked: "If I'm deeply interested in research and I don't see myself practicing clinical medicine, what should I do? Pursue residency? Get a PhD?"

This can be tough to answer because it really depends on so many variables. First, how do you know that you won't enjoy some type of clinical medicine? Have you considered all the options, or only the most common ones? Towards the end of the clinical clerkship years, medical students have gotten exposed to most of the common medical specialties, but they probably haven't rotated through specialties like pathology, PM&R, preventive medicine, and several others.

If you're absolutely certain that you don't want to pursue residency, then step back and look at your long-term career goals. For instance, if you want to do clinical research in pharma, then you probably should do a residency, publish some papers, become an academic faculty, and then make the transition. You don't need an MBA to be a researcher for industry.

If you want to work in hospital administration, then you'll need to have practical clinical experience. Hence, you need to do a residency to really understand the nuts and bolts of managing a hospital system.

My advice is always to try residency first. If you give it a fair chance before you pursue other options, because it's often very difficult to go back to clinical medicine.

The road to a PhD can be a very long one, so if you know that you want to focus on basic science research, then you may want to start down that path earlier than later. However, I would still encourage you to give residency a chance (and try to look for some creative options).

The Stability of Health IT in Today's Economy

There have been recent stories about jobs in the health IT industry. Despite all the instability in today's economy, the health IT sector seems to be booming. Hospitals are implementing changes and upgrading their systems. Information systems and technology have become integral parts of the healthcare infrastructure. More and more clinics and hospitals are becoming "digitized" and entering the digital world of electronic medical/health records (EMR/EHR). Plus, more and more patients are using personal health record (PHR) services to keep their own medical records portable and easily accessible. So, if you're considering a career change or you feel like an entrepreneur, then pursue opportunities in health care informatics (health IT, health IS/IT, EHR/PHR, etc.)

NY Times: Harvard Medical School and Ethics

There's a very interesting story on the NY Times about Harvard medical school and ethics as it relates to relationships with industry. We're primarily talking about the pharmaceutical and biotechnology industries, but we must also remember medical device and diagnostic equipment companies. In any case, Harvard professors are deeply involved in industry-funded research and many of them are also paid speakers and consultants for several of these companies. Conflict of interest is the key buzzword (or in this case, buzzphrase). How do you resolve any potential conflicts of interest in such situations? It can get quite complicated, especially if you have significant ties to industry. However, I believe that it can be done, but that's not to say that everyone out there is doing it correctly.

There have been many stories of highly-ranked academic professors quitting their academic careers to work for industry. I think people need to find what's right for them, and for some, a career in non-clinical medicine is the right fit. I personally know several people who have transitioned from academia to pharma and most of them seem to enjoy the different challenges and rewards faced in a corporate environment. Of course, there are pros and cons to every decision, including the decision about leaving academia. The bottom line is that it's a very personal decision.

Online Master of Science in Health Communication

Boston University (BU) offers an Online Master of Science in Health Communication. For those of you who are considering a career transition into medical communications, you may want to look into this relatively new degree program. I miss my days in Boston. It's such a wonderful city for a college student. However, if you don't live in Boston, you can still get educated by some of the great colleges in New England. Boston University is an internationally respected university with a reputation for excellence and extensive research and ranks among the Top 100 National Universities according to U.S. News & World Report college rankings. Boston University is regionally accredited by the New England Association of Schools and Colleges, Inc. (NEASC).

International Society for Medical Publication Professionals

Have you heard of International Society for Medical Publication Professionals (ISMPP) ? That's pronounced "Iz-Map"

They are having their 5th annual meeting in Philly. If you want to learn more about medical publishing and wish to network with others in this industry, then this might be a worthwhile meeting to attend. The ISMPP also offers distance learning via webinars through the ISMPP University for those who wish to learn more about the medical publishing industry.

The theme this year is: Defining Professionalism in Medical Publications: Transparency, Objectivity, and Ethics

The ISMPP also offers a certification program for those who wish to be a Certified Medical Publication Professional (CMPP). I wonder if that's where those in the CME industry came up with the Certified CME Professional (CCMEP).

Obama Picks Kansas Gov. Sebelius for HHS Secretary

I don't like to talk about politics very much, so I'll keep this brief. I think the headline speaks for itself. President Obama picked Kansas Gov. Kathleen Sebelius as the secretary of the Department of Health and Human Services (HHS).

If you're a clinician and you have a strong interest in politics, it may help to get involved in media campaigns and local public health service projects. If you get recognized, you may find yourself on television and you may even become famous!

GoDaddy Custom Domains and Blogger URL Forwarding/Redirect for Naked Domains

I wish to share something for my fellow bloggers using Blogger/Blogspot who purchase a custom domain through GoDaddy.

Here's the problem: if you purchase a domain (like be: medicineandtechnology.com) and then use Blogger, you have to include the www in the URL: be: www.medicineandtechnology.com

Blogger won't let you use the "naked domain" of medicineandtechnology.com

You need those triple w's (www), otherwise you may end up on a 404 (not found) or other dead page if you simply type: medicineandtechnology.com. In my case, I saw a generic GoDaddy page with lots of ads and links.

So what's the solution? Have GoDaddy redirect/forward : medicineandtechnology.com to: www.medicineandtechnology.com

This way, if a user enters be: medicineandtechnology.com, they automatically end up on be: www.medicineandtechnology.com

You can't set this redirect using Blogger, otherwise you'll get this error message:
Blogs may not be hosted at naked domains.
Many people have had problems using this URL forwarding/redirect within GoDaddy. I had some problems initially, but after some extensive reading, I found the correct configuration that currently works for me.

Here are the steps that worked for me and hopefully they will work for you too:

Set all these settings in the GoDaddy Domain Manager. Then, after you've set all these settings, make the change on Blogger/Blogspot to use the custom domain.

1. Namerservers (set to Parked)

NS17.DOMAINCONTROL.COM
NS18.DOMAINCONTROL.COM

If those aren't the nameservers you see, then click to change them to "custom," enter those namesevers, and then click to "parked"

2. DNS settings/revisions
Revise the "A Record @" and the "CNAME www"

• A Record @ 64.202.189.170
• CNAME www to ghs.google.com

4. Enable URL Forwarding
In my case, I set the forwarding URL to be: www.medicineandtechnology.com
Don't forget the triple w (www) in that URL forwarding address
Make sure you don't have a "/" at the end of your URL

5. After you make all these changes, go into Blogger and then enable your custom domain. Then wait a few hours or so, and hopefully it will work for you like it did for me.

Summer Pharmacy Internships

Now that it's already March, the summer will be here very quickly! If you're in pharmacy and you're looking for a summer internship, you may want to take a look at this list from the Pharmacy Times:
http://careers.pharmacytimes.com/articles/B66094EC.asp

Symbicort is now FDA approved for COPD

The FDA has approved the use of Symbicort (budesonide/formoterol) for the treatment of COPD. Symbicort is a combination inhaler that was originally approved for the treatment of asthma and is manufactured by AstraZeneca. Like many other new drugs, it has been available in Europe for a while now.

MBA Costs at U Mass Amherst Isenberg

As a member of the University of Massachusetts Amherst alumni association, I'd like to let people know about the Isenberg School of Business at UMass Amherst. They offer an flexible part-time MBA that is 100% online and is also endorsed by the American College of Physician Executives (ACPE). The Isenberg Part-Time MBA Program ranked 5th in the Northeast and 29th in the Nation by BusinessWeek. It is accredited by the AACSB and students even have the option of taking live courses on select UMass campus locations.

This is a 37-credit program that can be done over 4 years, but most students complete this program in 2 - 2.5 years while working full-time. If you've a physician and you've been thinking about pursuing an online MBA, this is one you should seriously consider. Each class will cost roughly $2,000 so that puts the entire program at roughly $25,000. At some universities, you'll easily pay over twice that amount to get an MBA.

So what are you waiting for? You can even take 1-2 classes as a non-degree student and then transfer those credits towards your MBA degree.

Overwhelmed by Medical Education?

Because of the wealth of medical information that is currently available on the Internet, I often wonder whether physicians, nurses, and pharmacists are overwhelmed by educational content. Some content may be inaccurate, outdated or biased, but the content is there. Is there enough? Or too much? We all know that certain disease states attract a ton of attention (e.g., diabetes, breast cancer, heart failure, etc.)

What about the less common conditions? Aplastic anemia? Swallow syncope? More and more healthcare professionals are using Internet search engines to find the answers to their clinical questions, but are the sources of information accurate and reliable? Unfortunately, most of the time the answer is no.

At the same time, clinicans are so busy that they hardly have any time to sit down and receive any formal education. So what's the best way to learn and to stay up-to-date on current topics? Medical technology is advancing so quickly that unless you're continually updated with new information, you'll quickly fall behind and continue old practice patterns.

Physicians and Social Networking

KevinMD has an interesting post about doctors potentially putting themselves at risk on social networking sites. Sermo is a FREE online community just for physicians and is one example of a closed, private social network. Doctors can post whatever they want in a closed environment, but if that information were made available to attorneys, then would that place a doctor at risk for malpractice lawsuits? As social networking grows within the medical community, these are some of the sensitive topics that are being brought up. I'm sure there are some doctors who avoid social networking websites purely because they fear that the information they post may somehow be used against them.

Getting Reconnected - How Time Flies

I had a really nice chat the other day with someone I hadn't spoken to in several years. We briefly chatted about health information technology, MIT, medical education, Web 2.0, and a local pharmacy school. It's great to have social networking resources to stay connected with people. Thanks you LinkedIn and Facebook. It's important to maintain relationships because you never know when you may need a professional reference, a job lead, or even a potential lead for a colleague.

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Best Online MBA for a Physician

This question comes up all the time: "What's the best online MBA for a physician?"

There's no easy answer, since it probably really depends on what that physician wants to do with that MBA. Is he/she interested in starting a business and becoming an entrepreneur? How about running a hospital? (in which case a master's in medical management of a master's in health administration may be more beneficial). What if you want to go into pharma? Do you need an MBA? No. However, if you want to work on the marketing side of pharma, then it may be very beneficial to have some marketing expertise.

An MBA can also be very useful if you want to go into finance or consulting. I've discovered that most physicians don't really understand the corporate business world. By "most" I mean those who go straight from a biology/chemistry/science undergraduate degree to medical school. They lack any "real world working experience." They've been a lifelong student!

Do some research before pursuing an MBA. Don't simply look for the "best" since one size doesn't fit all physicians. There are so many different non-clinical opportunities for physicians and you may find that an MBA is not usually required for most of them.

Free MIT education: Open Course Ware

Earlier, I mentioned free MIT education through the MIT Open Course Ware. If you're interested, take a look here:

http://ocw.mit.edu/OcwWeb/web/home/home/index.htm

It's a great way to spend time if you're in transition. Learn some new skills and be better prepared for your next opportunity. It's about lifelong learning.

Balancing Full-Time Jobs and Part-Time Education

It's tough enough balancing a full-time job and a personal/family life. When you add an educational degree on top of that, then it gets to be very tricky! There are many people who find that they are more productive when they're pushed to the limit. Of course, you can get burned out very quickly if you're being pushed to the extreme, so you have to know your limits.

For me, I enjoy reading and learning new things. In some ways, I wish I could be a lifelong student (as long as someone pays me so that I can pay the bills, take care of my loans, etc.). However, the reality is that we need to be productive with our time, resources, and talents. I enjoyed getting my MPH (master's in public health) while I was working full-time. It was motivating and stimulating. I admit that there were days when I just wanted to be finished with my MPH. Once I was done, I felt a huge sense of relief. However, I also know that I can do it again - and that's why I've been thinking about business school. I'm still not sure where (and if) it fits into my life and my career plan, but I hope that it will at some point.

If you've been considering a part-time education and you're currently working full-time, keep this in mind: many schools offer you the option to enroll in one or two classes as a non-degree student. This gives you the flexibility to test the waters and try things out first. If you find that the work/life/school balance is too difficult, then you may need to reconsider your options. However, I'd have to think that many people would find the balance manageable - as long as you prioritize wisely. If you have the luxury to stop your day job and enroll in a full-time educational program, then you're very lucky. That's probably the best learning option if you can afford such an investment. As for me, I need to play the balancing act of work/life/education in order to stay alive and support my family. That's the practical side of life.

Business Exchange

If you frequent BusinessWeek online, then you may have stumbled upon Business Exchange. It's still in beta, but it appears like a solid social networking site where you can exchange thoughtful ideas, opinions, and resources. Have you been thinking about business school? If you have unsettled questions about b-school (regarding tuition, online classes, etc.), then you should take a look.

For those healthcare professionals who are planning a transition to a non-clinical career, it may be a good investment of time to take some online business courses. Some are even offered for FREE, so why not?

Working in Medical Education

I've had many people ask me about the world of medical education. One might think that medical education is fairly simple and straight forward, but it's much more complex because of the need for certified continuing education. Then you have promotional medical education activities that may look like a robust educational program (but you have to recognize them as promotional activities).

How do you get your CME/CE? Do you attend major medical meetings? Do you participate in online educational activities? Do you read journals? Online web portals and online courses offer very convenient ways to get continuing education.

United Healthcare, Aetna, and Kaiser Permanente

What do these 3 health plans have in common? United Healthcare, Aetna, and Kaiser Permanente

They now offer expanded coverage of continuous glucose monitors (CGM) for patients with type 1 diabetes. It's great to see advances in technology that have tangible impact on disease management.

Last month, the American Diabetes Association (ADA) published its 2009 Standards of Medical Care in Diabetes. The new standards recommends the use of CGM in the following ways:

• Continuous glucose monitoring (CGM) in conjunction with intensive insulin regimens can be a useful tool to lower A1C in selected adults (age ≥25 years) with type 1 diabetes.
• Although the evidence for A1C lowering is less strong in children, teens, and younger adults, CGM may be helpful in these groups. Success correlates with adherence to ongoing use of the device.
• CGM may be a supplemental tool to SMBG in those with hypoglycemia unawareness and/or frequent hypoglycemic episodes.

One of the studies that provided robust data on the use of CGM was this New England Journal of Medicine article:

The Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group: Continuous glucose monitoring and intensive treatment of type 1 diabetes. N Engl J Med 359:1464–1476, 2008

Online Continuing Education

How do you get your continuing education? Do you take classes? Read? Online programs?

Many more people are getting their continuing education online. Do you ever consider getting an online master's degree (say an MBA, an MPH, an MEd, an MS, or an MA)? You've probably seen ads for Walden University, the University of Phoenix, Capella University, DeVry University, and others.

But did you know that some of the most prestigious universities offer online master's degrees? For instance, Johns Hopkins offers an online MPH program where the vast majority of the coursework is Internet-based. Emory University offers a similar online MPH.

Getting a master's degree has many benefits, even if you're a seasoned healthcare professional. There's a reason why executive MBA programs are so popular among senior-level corporate executives. There's so much you can learn in the classroom, but more importantly - there's so much you can learn from each of your colleagues and peers. If you're planning on a career change, then you may want to look at some sources of continuing education. Maybe it will be worth your investment to even enroll in a degree program.

Distance Learning: Online Education

As e-learning technologies improve, graduate-level distance learning programs are becoming stronger than ever. Want to see what your classmates look like? Then schedule a video conference call to work on a group project. These types of interactions are becoming more and more popular among today's online degree programs. Don't have time to sit in a classroom? Then watch the lecture online on your laptop.

There are obviously pro and cons to online education. However, for busy doctors and other healthcare professionals, the pros may far outweigh the cons. This may be especially true if you don't live in a major city where you may have access to executive and evening programs (such as an executive MBA). You'll have to decide after you do your research.

Master's in Medical Management

What do these 4 universities have in common?

• Carnegie Mellon University
• University of Southern California
• Tulane University
• University of Massachusetts Amherst

They offer either a master's in medical management (MMM) or a master's in business administration (MBA). Plus, they are the four schools that are ACPE partners.

The ACPE (American College of Physician Executives) is an organization that fosters the growth and development of physician leaders. You don't need to have a master's degree to be an excellent physician executive. However, there are many benefits of formal education in professional leadership, management, and business.

Growing Your Social Network

Because of the current economy, activity on social networking websites has gone through the roof. When I visit the forums and discussions on LinkedIn, I see many recruiters and job candidates actively looking for various types of opportunities. Some are in complete career transitionwhile others are simply looking for a minor change.

Have you been growing your social network? Even if you're in a stable position and you don't see yourself going anywhere anytime soon, I'd encourage you to maintain relationships with old colleagues, classmates, and co-workers. I admit that networking can be tiring and time-consuming, but the intangible benefits are worth that periodic investment.

Should I do a Medical/Surgical Residency?

I often get asked this question by medical students: "Should I do a medical/surgical residency if I KNOW that I never want to practice medicine?"

I always try to encourage medical students to go through residency. There are many types of non-malignant programs out there. Plus, you may find that you actually enjoy certain things about clinical medicine. Some residency programs to consider include preventive medicine and PM&R. No matter which program you select, residency can feel brutal if you end up isolating yourself from family and friends. Plus, you may suffer serious emotional burnout and psychological distress if you're not truly prepared to be a physician.

There are many non-clinical opportunities for medical school graduates who never go through a residency. The transition from the clinical world to the non-clinical world can be slow and arduous, but many have traveled this road with great success.

The European Commission Approves Efient (prasugrel

No, not Effient (which is the proposed US tradename). Efient (prasugrel) has been approved in Europe for acute coronary syndrome (ACS) patients undergoing PCI. The annoucement was made by Daiichi Sankyo Company, Limited and Eli Lilly and Company.

Two of the major prasugrel studies are:

• TRITON–TIMI 38 (Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition with Prasugrel–Thrombolysis in Myocardial Infarction), and
  
• TRILOGY ACS (TaRgeted platelet Inhibition to cLarify the Optimal strateGy to medicallY manage Acute Coronary Syndromes),

Prasugrel is a dihydropyridine that is currently under FDA review. The other dihydropyridine you're probably familiar with is Plavix (clopidogrel) which is marketed by sanofi-aventis U.S. LLC and Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership.

The American Physician Scientists Association

If you're a medical student of a physician with a strong background/interest in research, then you may want to consider attending the American Physician Scientists Association (APSA) meeting this year in Chicago. There are different levels of membership and it appears that you don't have to be an MD/PhD or a DO/PhD to be a full member.

Re: Non-Clinical Opportunities for International Medical Graduates

Someone recently asked: "Tell me about non-clinical opportunities for international medical graduates (IMGs or FMGs)"

My reply:

The opportunities are mostly the same when you're looking at things related to medical communications, consulting, writing, etc. In most of these cases, you don't need an active US medical license. Hence, whether you are an international graduate or a US graduate, the opportunities may be very similar. I'm not going to get into issues related to getting a work Visa because that's an entirely complex topic in and of itself.

Student Doctor Network Salary Expectations Survey

The SDN has a nice article based on a series of polls regarding salary expectations. Salary ranges among healthcare providers can vary so much that it can be very difficult to decipher published salary guides. The article on SDN also has links to mean wages from the U.S. Bureau of Labor Statistics (BLS).