Location: Roanoke, VA
Occupation: Professor & Chair, Virginia Tech Carilion School of Medicine; Pediatrician-in-Chief, Carilion Clinic Children’s Hospital
Websites: Alice’s Carilion Clinic Blog, @CloseToHomeMD on Twitter
Favorite Wildlife: Birds
Q: You came from very humble beginnings in Brooklyn, NY, to have an incredibly successful career in medicine. How did you first discover your interest in medicine?
There were a couple of related events. The first was when my father died, when I was nine years old. At some point after he passed away, I remember coming out of my bedroom, and looking at my mom, and she was trying to figure out how to write a check and how to balance a checkbook. And she was crying.
And I sat there, and I said, somewhere inside of me, that this was not going to happen to me. I think that gave me the desire to become self-sufficient, to value my education, and to go forward with the mindset that I was going to rely on myself.
I also remember when I was in highschool, I volunteered at Coney Island hospital. I was volunteering at an ER when they were responding to a cardiac arrest. And the doctors were working on some poor man they had brought in, and they were unsuccessful. Afterwards, they just walked away, with the attitude “you win some, you lose some.” And I wondered if they treated my Dad like that when he was brought in, or if there was someone there who really cared. And that’s what I think really set the stage for the person I was going to become.
Q: You were basically raised by your mother after that. How did your relationship with her impact you?
She was an incredibly strong, inspirational role model for me in so many ways. Except for that one time I saw her crying at the kitchen table, she was really an upbeat, happy person who always strived to improve herself.
It irritates me when I see people — and it’s mostly women — who don’t feel fulfilled if they don’t have a man. That was just not where I was headed. I had managed to do very well in high school, and had graduated with some high GPA. My mom, she was Italian, and in the Italian tradition (her parents had come over from Italy), the daughter is responsible for taking care of the parents. And my mom said, “You can’t leave me. I need you to take care of me!” And I said, “Mom, I am going to take care of you. But I can do a lot better job of that if I go to college than if I become a secretary or stay with you right now.” But I knew I had to go, because I knew if I didn’t, I knew I’d find myself in a dependent situation down the road.
Q: Neurosurgery was your early passion, but you wound up becoming a pediatrician. How did that journey happen for you?
I continue to be fascinated with how the brain works. It’s fascinating how, as humans, we respond to injury, and I saw neurosurgery as being a more active specialty than neurology. At the time, neurology was much more about caring for someone who had something wrong with them — who was going to die — and there wasn’t anything you’d be able to do for them. But neurosurgery gave me hope that I could really help the people they brought in.
“What makes someone go into a coma?” “How could they treat it, how could they avoid it?” Those were the questions I wanted to answer.
But then I did a rotation in pediatrics. While I was doing it, I just found that I was happy. It’s really amazing, because my whole face just changes. My interns or residents just tell me — even today — that they see how much I love my patients. When I’m doing it, it just feels like this is what I was meant to do. It was an epiphany, but it wasn’t a conscious one, and it’s what I now consider my home in medicine.
Q: Was it an easy decision to make, to become a pediatrician? Were the people around you at the time supportive of that choice?
When I went in to tell the dean of my medical school that I was going to choose pediatrics, he was very disappointed. He said, “My dear, but you’re good enough to do medicine.” It’s indelibly etched into my mind. It was an incredible eye-opener for me. But it really didn’t faze me, because I really felt so sure about it. I feel a little bad about it when I try to mentor students today, because they feel like they need to know what they’re going to do when they enter, and I tell them that’s not true.
If I were to sit down and think about it, I think medicine might have been one of the last things I’d wanted to do, because in internal medicine, most of the diseases people face are the results of years of bad decisions that they make. And a lot of people say I’ve taken the easy way out, but I feel that this career, as a pediatrician, really gives us a chance to make a difference, and to have a lasting impact on families throughout their lives and also passed on to subsequent generations. It turns out that things like toxic stress can adversely affect not only a child, but that can be passed down to their children as well. I think that pediatrics becomes much more attractive when we start talking about population health and global health, and we really have an opportunity to have a lasting impact. I still feel, to this day, that I made the right decision. And I still see that a lot of people who chose other fields — like internal medicine — aren’t as happy with their lives.
Q: For most of my friends who are doctors, going from college to med school to an internship followed by a residency is all the “schooling” they can handle. But you have your M.B.A. on top of that!
Gotta keep that brain fresh, you know! <laughter> I don’t want to get senile!
Why did I get an MBA? I had been working in the same place, doing the same job for about 20 years, with a few variations. I was not ready, at that point in time, to move or change jobs, but I wanted a challenge, and I wanted something to break me out of the box I’d been thinking in.
I had always been interested the business of medicine, but I didn’t want to have anything to do with physicians; I wanted to be in there with business people. When you surround yourself with the same people all the time, you really get into that same way of thinking. But we had a big diversity of people in this program, a variety of backgrounds: retail, infrastructure, banking, construction, someone worked for Verizon, another for Under Armour, etc. I just loved it, and I did it because I needed some short-term goals. At that point, I didn’t have a specific career-based goal at my place of work, so I was looking for something to stimulate me, my brain, to make me read, and solve problems I’ve never solved before.
Q: You’re also very passionate about improving outpatient care. What do you wish more parents and patients understood about that?
I think — and it does get fairly complex — that most children are generally healthy. Most children don’t really need a doctor all the time. Their growth, development, and vaccines need to be tracked and charted. But pediatricians are trained to care about children’s health, how to keep them healthy, and how to spot any potential issues before they become too difficult to deal with. Recommendations change over time — your grandmother doesn’t always know best — but what I see going on with outpatient care is that something like 5% of children wind up having special healthcare needs. And there’s a wide variety among them.
For example, a child is born with spina bifida, they may have stomach problems, behavioral problems, etc. I’m here in Roanoke, in SW Virginia, which is fairly rural, and my dream is to have this increasing percentage of kids with special needs having access to the physicians and the experts who have the knowledge they need, as close as possible to where they live.
Q: It sounds like what you’re talking about is making medicine faster and more responsive to the needs of your patients and your potential patients.
My dream gets embodied when I think about it as this building: an outpatient clinic. The other piece of it is that I want people to realize that healthcare, these days, is not just about medicine. Healthcare is provided by an entire community, and in order to optimize a child’s health, we have to give them access to different services. When I think about that “it takes a village” concept, it really rings true. My goal is really to build a sort-of adjunct healthcare village in the lobby of this the building. I’d like to bring these groups and services that all kids need — especially kids with special, extra needs — who are now scattered around this city in, so that they have one-stop access to everything they need. When someone comes in to see the pediatrician, and I order them a special formula, that’s just available downstairs. I’d like to make it much easier and simpler, and to have translators on-site, so that when you have a specialist who’s not bilingual, you can make the entire experience that much more comfortable for everyone.
Q: You’re also working very hard to raise awareness over social media about medicine.
I think we’re all doing it differently, and I’m finding it interesting that people think what I’m doing is extraordinary. I’m coming to realize that fewer than 1% of physicians are actively engaged in social media. There’s a lot of fear out there about what might happen. I was reading today about physicians on twitter, and whether those who have chosen to allow themselves to be known by name versus the pseudonymous ones, and the Australian Medical Society came out and said that you shouldn’t be anonymous as a physician. If you’re going to identify yourself as a physician, you really need to be transparent about who you are. There are a bunch of people that would like to be involved, and it’s a growing community of physicians and healthcare providers, and the number of patients wanting access is also growing. Social media has given me the opportunity to interact with people I never would have interacted with otherwise.
My entry into social media was via my blog; this coming September, it will mark 3 years since I started. I barely even knew what Twitter was back then, but now I think it’s incredibly powerful. I see a growing number of healthcare providers that are very active there. There are Twitter chats that we have weekly in many different areas, that can allow us to talk to each other and ask questions of each other. We wound up telling stories of a “vaccine town hall,” and vaccine-preventable diseases, which I was trying to raise awareness about on my blog. And I saw a Twitter chat on that exact topic. And there were plenty of parents reading this chat, and one of the moms said that she was anti-vaccine but now she’s pro-vax, and she mentioned that it was Alice Ackerman’s blog that changed her mind! I realized that if I changed this one woman’s mind, maybe I changed others, too. She’s writing about this stuff in a way that’s accessible, maybe she doesn’t have an ulterior motive, maybe she’s just trying to help my child.
Had those things not come together, I might never have known about the positive impacts of what I was doing. That really solidified my interest, and justified my spending time to find content, and to write something; it made me feel like there’s a real point to this, and maybe this is useful. That’s what solidified my interest in social media.
Q: And one of the tools you use over social media is Trapit. Can you tell us about your experience with us?
As far as Trapit goes, I am totally loving it! I learned of it through Buffer, which up until now has been my absolute favorite Twitter app. When I explored Trapit I was fascinated at how easy and intuitive it was; I was feeling like an expert in no time!
I use it to simplify my life, help me find and read interesting material in a very short time, and if I want to, jump from one topic to another easily. Once I have read a piece, I can decide if I want to share it and I’ll hit the Buffer icon, which then allows me to share to any of my platforms: Twitter, Facebook or LinkedIn. Most of the time I only share to Twitter. But since I usually have time to browse only once or twice a day, I don’t have to send all my great finds out at once; the pieces can go out throughout the day at times that I know most of my followers are online.
Q: Has using Trapit in conjunction with Buffer helped you more effectively engage with your followers?
In the beginning, I was sending out tweets with just the title of the article and the link, but people didn’t seem to be clicking, favoriting or RTing very much. So I started writing a couple of words at the beginning — just in my own words — like “a wonderful read,” and I can tell that people are clicking more. I can track that through Buffer, and the share rate has really gone up.
I’ve definitely seen a jump in my retweets since I started using Trapit to find and share interesting articles about my favorite topics. People are really going through Trapit and accessing the article much more than they were before I started using it.
Q: You’re using Trapit on the iPad, which we’re hoping you find incredibly convenient. What has your experience with it been like?
It’s pretty much now one of the first things I do in the morning, and one of the last things I do before I go to bed. It brings me all of this information on so many different topics, and it’s all in one place. It’s incredibly portable, too, so I can take it with me anywhere I go, as well as just have it with me on the couch when I’m watching TV at night.
I’ve been so happy since I’ve found Trapit. It’s really maximized my ability to share these interesting, new, and not necessarily common stories that I’ll find. It’s allowing me to share less commonly quoted sources that are still reliable, and it’s finding quality, unique voices. I probably could have eventually found them on my own, but I would have had to spend a lot of time slogging through a laborious search.
Q: What are your favorite topics to follow, and your favorite traps that you’ve created?
To name a few, I’ve created traps on autism, children’s hospital, big data, artificial intelligence, and on gluten-free (where I often pick up recipes). I’m busy with my work from 7 in the morning until 7 at night, and so I don’t have two hours to just sit and comb through information, or read my entire Twitter feed. Having Trapit at my fingertips not only makes me more productive, it helps me to keep people’s interest in my Twitter feed, which gives me a better way to share my own content as well.
Q: Thanks for such an enlightening interview. Is there any final message you’d like to leave to other medical professionals about the importance of being professionally social?
I think that there’s no way that the Internet is going to be policeable, and we don’t want it to be. So those of us who are knowledgeable in certain areas have to help the average person make sense of and distinguish between what’s based in fact versus what’s based in emotion or conjecture. If someone’s going to base their healthcare decisions based on something they found on the Internet, they need to be able to know what a reliable physician says about that. As a doctor, a nurse, a PhD in the biological sciences, we should be able to help people make sense of what’s out there.
I feel some responsibility to the population to say, “Am I going to be able to help you make decisions?” I’m not giving direct medical advice, but I am giving quality information. Decisions about vaccinating pregnant women against pertussis with each pregnancy might not make it into the mainstream, but if I can write about it and tweet it out to people, it’s a way to share information about what’s recommended by the academy of pediatrics or other reliable organizations.
Alice Ackerman is a Professor and the Chair of the Department of Pediatrics at Virginia Tech’s Carilion School of Medicine, as well as the Pediatrician-in-Chief at Carilion Clinic Children’s Hospital. Her blog at the Carilion Clinic can be found here, and she tweets as @CloseToHomeMD on Twitter.
