Jul 28, 2019
The ONE day I’m off work and have no other plans, EVERYONE EVERYWHERE IS FUCKIN DEAD.
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The ONE day I’m off work and have no other plans, EVERYONE EVERYWHERE IS FUCKIN DEAD.
The main game of the weekend was the Ruhr derby between Schalke and Dortmund and five African stars played their bit. Schalke, who lost 2-1 to the leaders, had Salif Sane, Nabil Benteleb and Amine Harit start the game. Hamza Mendyl was a second-half substitute. For Dortmund Moroccan international Achraf Hakimi once again started the game as the Black and Yellows maintained their seven-point lead at the top. There was a first start of the season for Guinea international Ibrahima Traore as Gladbach moved back to second in the table with a 3-0 victory against struggling VfB Stuttgart. The other match on Sunday saw three African on the field for Mainz as they were held to a disappointing 1-1 draw by Hanover. Jean Philippe Gbamin and Pierre Kunde Malong started for the home side, while Anthony Ujah came on in the second half. The Nigerian forward thought he had given his team victory in injury time, but his header was ruled offside. Algerian Ishak Belfodil had more luck with his attempt as his goal gave Hoffenheim an early lead in Wolfsburg. The game ended in a 2-2 draw. In Berlin, Hertha got back to their winning ways with a 1-0 against Frankfurt – a result that keeps the side from the capital challenging for a European place. Solomon Kalou started for the home side. Make sure you stay tuned to StarTimes to watch African stars in the Bundesliga. Brought to you exclusively and live by StarTimes. #bundesliga #footballasitsmeanttobe #fmig #fmigtv (at Schalke04 Stadium) https://www.instagram.com/p/BrNRMnLhIa8/?utm_source=ig_tumblr_share&igshid=5a83zv2opxat
Borussia Dortmund are just one win away from winning the Autumn championship. A 2-1 victory in the Ruhr derby at Schalke sees the Black and Yellows continue to hold a seven-point lead over Borussia Moenchengladbach, who managed to beat Stuttgart 3-0 on Sunday. And although the Autumn championship consist of little more than bragging rights, it does strengthen Dortmund’s case of being a real challenger for the Bundesliga title this year. Bayern Munich, who were expected to have an easy passage to yet another league title, secured a 3-0 win at home against Nuremberg, with Polish striker Robert Lewandowski grabbing two. The Bavarians remain nine points behind Dortmund though. In Freiburg the home side started the game with an all-German starting XI and they proved too strong for the visiting RB Leipzig side, who were beaten 3-0. At the wrong end of the table, Hannover managed to pick up a point at Mainz, but Dusseldorf were convincingly beaten 3-1 at Werder Bremen. Hertha Berlin and Bayer Leverkusen secured 1-0 victories, beating Frankfurt and Augsburg respectively, while the final match saw Wolfsburg and Hoffenheim play to an exciting 2-2 draw. To keep up to date with the best league in the world, make sure you catch the Bundesliga. Brought to you live and exclusively throughout Africa only on the StarTimes channels. #bundesliga #footballasitsmeanttobe #fmig #fmigtv (at Munich, Germany) https://www.instagram.com/p/BrNQ1O-Bkvz/?utm_source=ig_tumblr_share&igshid=h9d73a8ovacq
Anthony Ujah is our African Star of the week. The Nigerian is powerful and versatile forward that is a threat down the centre of the park and ruthless on the wings. He attained cult status during his time @Lillestrøm before making the move Europe’s most exciting league @bundesliga_en where he is a stalwart breaking goal droughts and claiming vital points for the clubs he plays for. We salute you @ujah21 you are an inspiration to all aspiring footballers and an ambassador of African football, but most of all you are an African Star. #startimes #bundesliga #footballasitsmeanttobe #africanstars #fmig (at Makurdi, Benue State Capital) https://www.instagram.com/p/BrDoXu0Bq6-/?utm_source=ig_tumblr_share&igshid=qony6dpswedt
There's No App For That
I now live in in the San Francisco Bay Area, a technology hub, with a lot of start-ups and young entrepreneurs designing the next big thing. As part of a start-up Residency myself, I was wondering how to be truly innovative in medicine. So I have been thinking a great deal about the intersection of medicine and technology. At first glance, the outlook is a bit scary: Artificial Intelligence (AI) taking over our profession, being replaced by machines… But, upon further reflection, my view has evolved, and I would like to invite you to start a conversation about technology in medicine; what it can and what it cannot do.
Let me begin by telling you a story of a patient that I saw recently in my clinic.
It seemed like a fairly simple office visit. The patient needed a note to go back to work. She was a recent immigrant who had been working as a dishwasher for the first time in her life and had developed an overuse tendinitis of her wrist. I walked into the room thinking: “this should be quick”. I saw a young woman who seemed to be in a rush to get out of the office; shy, and visibly uncomfortable. She mentioned that her wrist still hurts some, but then she said: “I just need that note...I cannot afford to lose my job”. There was just the slightest desperation in her voice and a fear in her eyes that I could not ignore. Those who already know me easily imagine what came next. Famous three words: “tell me more”. Then the story came of a political refugee, tormented by nightmares, unable to sleep for the past three months, having frequent panic attacks but pretending to be a happy-go-lucky person just to keep her job. She had decided to move out of her current housing and start paying for rent, and this is the reason why she could not lose her job. Well, the quick visit was not that simple after all. This young, courageous woman needed a note to get back to work. She also needed to get connected to multiple social services. She needed care for an undiagnosed PTSD and, most of all, she needed someone on her side.
What would have happened if I had been looking at the keyboard instead of looking in her eyes? Or if she had used a computer to input her chief complaint? “wrist pain resolved”; note back to work? She might have not even been given an appointment.
From the outside, a medical encounter can look like a very mechanistic exchange of information. Patient inputs history, signs and symptoms. The doctor processes the data, performs a physical and test, and the output is an assessment and plan. Patient goes home, does as the doctor says ....all is good. It would make sense to reduce it to that and design AI to carry it through. And entrepreneurs are listening: a good number of medical students are graduating to work on IT start-ups; hundreds of medical apps are available to download every couple of months.
Technology has advanced at an incredible speed, and it will continue to advance in ways unimaginable. New apps to support medical diagnosis, medical decision making, and dictation efficiency. From the patient's point of view, new apps for self-monitoring and self-management are available for anyone with a smart-phone or tablet.
My call to action, has two interconnected components:
First, let's fully embrace technology into our busy clinical lives. Let a computer do what it can do best. How great to have the computer calculate the dose for that baby's antibiotic, warn you about drug interactions, an app that will show you a couple pictures to help you diagnose that rash. Letting your patients input their medical history into their medical record before you even see them. An app that will send your patient's BG, BP, and weight directly into their record and suggest an appropriate medication change based on an algorithm. All of that is already possible and happening. There are many examples of efficiencies that can be gained from the implementation of technology in a clinical environment, which should translate into a rich personal patient interaction; this is what physicians have been trained to do. The gained efficiencies will allow us to have more engaging and deeper interactions with our patients. It will result in better care and more gratifying experiences for both patient and provider, not unlike the interaction that took place in the story I just shared.
The second component of my call to action is to commit the effort to hone the “soft skills” that make our profession an art. An art that complements technology and science to make our profession whole. An art made of the elements of the physician-patient interaction; the parts that technology can't do for us. I know it is possible because I have seen this in action with my trainees. Residents being truly present, accepting and caring; drawing from empathy and compassion. Bringing one’s best self to that moment when a patient is being most vulnerable, to encourage that patient to be more transparent and at ease. Picking up on their undisclosed challenges related to the ups and downs of chronic disease, and facilitating long lasting behavior change.
Our irreplaceable emotional IQ. There is no app for that.
Only you.
by Catalina Triana, MD
Dr. Triana is the Associate Program Director for the Family Medicine Residency Program at John Muir Health, located in Walnut Creek, CA. She has been teaching behavioral medicine, patient-centered communication and primary care counseling skills to family medicine residents and medical students since 2002. She is a Motivational Interviewing Trainer (member of MINT) and is passionate about teaching skills to facilitate health behavior change.
Hello! So from what I've gathered it seems like you are going into Family Medicine. A few classmate of mine and I run the FM Interest Group at our school. I was wondering if you had any tips on topics, activities, etc for FMIG events? What would you do if you ran the FMIG at your school?
Well buddy, you're in luck, because I DID sorta run the FMIG at my school. I was president during my second year (although the other officers did just as much work as I did).
We didn't get to do nearly as much as we would have liked during the year (due to low funds and not great interest in the student body), but here's some ideas. I put stars by the ones we actually did.
*Tar Wars I highly recommend this. It's fun, it requires minimal training, it looks good on CVs if you do it a bunch, and it teaches kids not to smoke. The AAFP will provide you with the materials. You talk to elementary school kids (get them before they start being offered cigarettes) and teach them the dangers of smoking, the cost of it, and about how advertisers try to trick them into buying cigarettes. Teachers are glad for the break during the day, and the kids really enjoyed it. If you get enough people to sign up, you can divide up into multiple classes and cover major ground.
*Casting workshop - find a FM doc who does sports medicine to come teach you how to make casts. You could also have someone come talk about durable medical equipment (aka splints, boots, wraps, braces, etc). If you find someone really awesome, you might could convince them to do a joint injection workshop. Those are awesome. A big crowd pleaser at my school.
*Wilderness Medicine Workshop - We happened to know a family doc who did a lot of wilderness medicine training, so he came and taught us how to stabilize fractures in the wild and safely transport people out. Another crowd pleaser. There are wilderness medicine conferences around the country throughout the year that you could go to, too. You could also check with the Wilderness Medical Society and see if there's a member near you who would like to speak to your group.
talks from 4th years going into FM about why they chose the field -easy to plan and relevant.
talks from residents about what FM residency is like
*talks from community/academic/rural FM docs about what they do, why they chose FM and whether they'd do it all over again
presentations from FM residency programs (especially ones in your state) - lots of FM programs are glad to come give presentations. They're always looking for quality students to become their next crop of residents.