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Medscape’s Pre-Rounds Interview With Dr. Val

I was recently interviewed about my blog (and this week’s edition of Grand Rounds) by Dr. Nick Genes at Medscape.  For the curious among you – here is the full Medscape interview with Nick Genes (prior to editing).  It gives you a little more information about Revolution Health…

1.      You’ve
been involved in writing since medical school, for various audiences. Who are
you trying to reach with your new blog, and how have you found blogging to be
different than the other media you’ve worked in?

The best part about
blogging is that it’s a dialogue rather than a monologue.  I find the interactive discussions and
heartfelt responses to be touching and engaging.  My previous writing was more academic because
of the medium (medical journals) but now I’ve found that blogging is where I
can really be myself – there is no team of reviewers to scrub my words.  So what you read is what you get!

2.      I’m
very curious about Revolution Health, your role as Senior Medical Director, and
where you think this is all going. But all revolutions have their origins
somewhere, and yours seems to start… on a yogurt farm. Please share a little
of what that was like, and maybe what early influences have given you such an
interesting background. From small towns to New York City, from theology to medicine, it
seems like you’re living a very rich life.

Yes, I guess you could
say that my origins as a revolutionary are firmly rooted in dairy farming.  Although it may not be immediately apparent
how the two are related, Internet startups and cattle herding have their similarities.  First, you have to wear many hats – there is
no job too small or too large.  If the
cows need milking, and the electric machines are broken, you do it by hand.  If a cow breaks through the fence and wanders
off into town, you lure her back with short feed.  If a large batch of yogurt curdles, you’ve
got yourself a gourmet meal for your pigs… you get the drift.  In a large start up, all manner of unexpected
events happen – but the trick is to handle them quickly and efficiently, and
make sure the outcome is a win-win.

As far as my other
life detours… I guess you can say that I’ve been a victim of my own
curiosity.  There are so many interesting
things going on, I just can’t help but want to try them out.  In the past I’ve held jobs in the following
capacities:

A protestant minister,
NYC bartender, bank spy, food critic, doctor, cartoonist, computer sales
associate, yogurt mogul, nanny, motivational speaker, biophysics researcher,
graphic designer and revolutionary medical director.

So my life has
certainly been an adventure!

3. How did you get involved with this company? Did Steve
Case find you, or know you from before — or was there an application process?
Is the mingling of medical and computer technology folks going smoothly? Is it a
mix of hospital culture vs. laid-back internet start-up culture? (Foosball and
mountain bikes, or suits and meetings?) Can you make comparisons to your time
with MedGenMed?

A friend of mine had
interviewed at Revolution Health for an executive position and thought that the
company would be a great fit for me.
When I heard who was involved (including Colin Powell, Steve Case, Carly
Fiorina) and that the goal was to create a website  to help patients navigate the health care
system, I thought – gee, this sounds serious, challenging and worthwhile.  So I sent in my resume, got offered an
interview, put on a bright red suit and announced that I’d heard that there was
a revolution afoot and wondered where I could sign up.  They hired me that same day (May 8, 2006) and
it’s been the most exciting job I’ve had to date!

About the “mingling”-
a very interesting question.  There is a
hint of Foosball/mountain bike in the mix, but I think we’re a little more hard
driving than that.  Since Revolution
Health is in its start up phase, there is simply too much work to do for people
to be playing Foosball.  When I started,
there were 30 employees, now there are closer to 300.  We are all working long hours on cutting edge
projects that I believe will make a big difference in supporting the
physician-patient relationship, streamlining the process of healthcare delivery
and improving accessibility to the uninsured and underinsured.  Revolution has attracted some of the
brightest minds in the tech industry – and they are building products I could
never have dreamed of on my own. Since I have such an unusual background,
I’m  bilingual in both techie speak and
physician speak, and this helps a great deal.
Because I understand what physicians and patients need, and can translate
that for the “creatives” we can build some really meaningful tools and products
together.

My time at MedGenMed
was wonderful, primarily because Dr. George Lundberg is a dear friend and
mentor.  He has done fantastic work
creating a pure platform (no pharma influence or fees for readers or authors)
for open-access publishing.  He taught me
to speak my mind, follow my gut and never compromise my ethics.  His book, “Severed Trust” galvanized me into
action – to do my part to improve the damaged physician-patient relationship
that is at the core of our broken system (caused by middle men, volume
pressures and decreased time with patients).
After reading his book, I wanted to do something big – so I joined a
revolution.

3.      Revolution
Health has some bold ideas about improving care for its members — getting
appointments with specialists, patient advocacy in dealing with insurance, and
of course, sharing information. What’s your job entail, as medical
director? Do you think you’ll find yourself making policy decisions that
could affect, directly or indirectly, chunks of the population? Could
you find yourself in a position where some specialists are not recommended
based on their insurance? Will Revolution Health have a formulary, will it
be evidence-based — or could could care be rationed ?

My job is incredibly
challenging and fun, and I rely on both halves of my brain for much of what I
do.  We have 146 medical experts most of
whom I’ve personally recruited, I’m responsible for coordinating the medical
review of all the content on our portal (so that it conforms with
evidence-based standards), I facilitate relationships with major hospital
systems (such as Columbia University Medical Center), spearhead new product
initiatives (such as Health Pages for physicians), monitor and promote our 30+
expert bloggers, participate in writing press releases, creating podcasts, radio interviews,
identifying new partnership opportunities and much more.

I do think that
Revolution Health will greatly influence vast “chunks” of the population.  And this is what’s particularly exciting
about working here.  We really are
building a brand new navigational system for healthcare – and this will empower
patients to take control of their health and provide them with better
information and guidance in living their best.
I believe that Revolution Health will become the new virtual medical
home for physicians and patients, just the way that AOL grew to be America’s
Internet home.  You log on first to AOL
to get your email, check your news, and get plugged in before surfing the
net.  You’ll log in to Revolution Health
to track your health, connect with your lifestyle coach or physician guide, get
involved with a community of others like you, or track your loved ones’ health
issues through Care Pages.  This is a 20
year project, so all of our plans and programming may not be apparent yet, but
the trajectory is amazing and I wouldn’t want to be anywhere else as a
physician today.

5. What are some of your favorite posts — something that
struck a nerve with readers, or captured something you wanted to express?
Please provide links!

My absolute favorite
post
is the story of how my mom, a strong patient advocate, saved my life as a
baby.  She refused to accept the
misdiagnosis I was given, and continued to nag the medical team until they
realized what was wrong and took me to the O.R.
If it hadn’t been for her persistence (or the incredible skill of the
surgeon who ultimately took care of me), I wouldn’t be here today.  And maybe that’s why I’m passionate about
both good medical care AND patient empowerment!

Other posts that have
been well received are true stories from my medical training days.  Some are controversial (like this one about
end of life issues and my first day as a doctor),
and others are warmer reflections.  But ultimately, I just share what’s on my
heart and let the audience take away what they can from it.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

2 Medical Blogs Shut Down

Superstar medical blogger KevinMD calls today (May 16, 2007) “Black Wednesday” – the day when two of the Internet’s most popular blogs were officially closed.  Both Flea and Fat Doctor were forced to shut down their blogs due to privacy concerns.  The two bloggers had been posting anonymously – in order to protect themselves and the privacy of the people they wrote about.  It seems that Fat Doctor was outed by a co-worker, and Flea… we don’t know what happened exactly, but he was in the middle of a malpractice lawsuit, and was revealing the unsavory details of how the trial was going.

And this news is timely, coming on the heels of an interview I did with USA Today about blogging and patient privacy.

This seems to me like a wake up call for medical bloggers – there is no such thing as true anonymity.  Your identity can only be hidden for so long.

I have never blogged anonymously – and I recognize that anything I post can be read by anyone, anytime, anywhere.  This knowledge has resulted in extreme caution in posting information that could even remotely be linked to a real patient.  And yes, I have also refrained from blogging about issues and events that I sure would have liked to because of the associated risks.

It may be time for us medical bloggers to create and adhere to a code of conduct to protect ourselves and our patients from harm.  I had actually proposed this to Dr. Rob a few weeks ago…

What do you think?This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

US healthcare then and now: 1907-2007

We have met the enemy and he is us.

  • Walt Kelly

From an article published in JAMA on February 16, 1907:

It is strange that the hospitals and dispensaries of this country should be so shamelessly flooded with pseudo-charity patients, having no claim whatsoever to gratuitous service. It can be explained only on two hypotheses: First, the working of that innate trait of human nature which prompts to obtain something for nothing, and, second, the lack of good business discrimination on the part of the institutions whose benefits are thus abused.

This quote is almost 100 years old to the day. Does anyone see any similarities to today’s emergency department or medical practice?

This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

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