Why doesn't SDN have a Think Tank?

[Frazier]

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First for those unaware of what a "Think Tank" is:

Think tanks are supposed to be incubators for ideas. With the executive and legislative branches largely consumed with the crisis of the moment, think tanks are places where policy communications strategies can be developed outside the daily pressures of Congress or the White House and without the overlay of personal political imperative that the staffs of the President and Members of Congress constantly worry about. (Matt Bennett, Vice President for Public Affairs, Third Way)

The best think-tanks are grounded in the real lives of real people. They listen to the challenges of regular residents and community leaders – and are led by those voices. The best think-tanks take their skills and talents at crafting public policy and conducting research and use them to tackle the problems of real people. They go beyond their towers and their silos and bring the concerns and ideas of the community to their work. They look to local policy innovations to see what could be useful for other areas, either by replicating it or by drawing on its core principles. (Judith Bell, President, PolicyLink)

Let 'em rip -- the scholars and thinkers, that is -- and help get their ideas out to a variety of audiences in a variety of ways. (Walter Olson, Senior Fellow, Cato Institute)

There are literally hundreds of these organizations in existence across the globe. They span different political orientations and have numerous different "interests". Some are large and renowned; others are small and relatively unknown...but what they all have in common is that they want to be proactive, they want to change and improve some facet of XYZ and by god that is what they are going to strive to accomplish. So, where is the voice of healthcare?

After checking up on various healthcare policy issues and reviewing the "woes" of the AMA's current state of existence, this question crossed my mind: Why doesn't SDN have a Think Tank?

In the early 1950s, about 75% of US physicians were AMA members. A 2011 article asserted that "somewhere in the neighborhood of 15% of practicing US doctors now belong to the AMA."

"The decades-long membership decline at the American Medical Association (AMA) shows no signs of slowing, which has some doctors worried that the national voice of their profession may one day fall silent."

SDN has certain assets that are not found in many other arenas (these assets facilitate not only with getting a powerfully collective message to organizations such as the AMA, but also offer the ability to reach numerous other people both working inside healthcare and outside of it):

• Thousands of active members across a wide range of disciplines from medical specialties (FM to PRS), to public health, both allopathic and osteopathic representation.
  
• A surplus of highly educated individuals that can communicate well (both written and orally).
  
• We have viewpoints of those facing the stress of sometimes archaic medical school curriculum. We have perspectives of those suffering through residency. We have thousands upon thousands of hours of insight from the experiences of those MD/DO's out in the trenches.
  
• An already developed and well-integrated communication/network system (the forums: both public access and private)
  
• An established and popular presence on the internet (studentdoctor.net reaches many [MANY] eyes from article readers, to forum lurkers, to SDN regulars, Google recognizes SDN's pages (pagerank) and typically rewards SDN with high page placement in the search results, etc.)
  
• SDN is already established with a donation system. The public outreach facet of SDN can have its own donation platform...one for doing OUR part, striving to impact policy to the best of our abilities.

Why not just start a think tank independently? SDN is an organization that is well-positioned to make this move for positive change. There is no other nonprofit that I know of that is as developed across different communication mediums and with as large of a reach across the different healthcare disciplines (as outlined above). It would take years (plus a lot of capital) to get a nonprofit to SDN's prominence from scratch... It just isn't even close.

I cannot count the times that someone posted an idea for an innovative change in the system and the response was simply "you should write a letter to your state representative". That likely won't get the job done. Building a network of proactive med students, residents, fellows, community physicians, academic physicians, and retired physicians will have a much larger impact than "hey, write a lone letter to your congressman".

SDN has recently been built upon anonymity and simple message board chatter. However, with NickNaylor and mmcdowe's recent youtube video, precedent was set that it can be much more. Becoming a "public figure" doesn't have to be negative.

I know if SDN became more than just a "message board full of neurotics/gunners", I wouldn't be hesitant to spread the word about it to every student/resident/physician I meet. It currently often comes with negative imagery of "gunnery". What if it became aligned with make a meaningful impact on healthcare?

It may take several years to grow in size and scope, but it can grow. Medical school chapters can be formed; annual meetings can be arranged. SDN started with a single member; today it has over 300k members and over 40k active members at any given moment. True they all aren't in precisely medicine... however, it shows that the potential REACH is there.

Perhaps it would be easier to form under a name different than "SDN" but aligned and integrated into SDN (such as what was done with panda's blog, or more recently, mdapplicants).

I look forward to your ideas on the matter.

No one is going to change anything unless unity is formed, numbers are grown, and messages are propagated to the masses.

Many are unsatisfied with the AMA. Many are unsatisfied with having an interest rate of 6.8% on our unsubsidized, nondischargable debt. Many are unsatisfied with how physicians are treated by CMS. Many are unsatisfied with midlevel encroachment. Many are unsatisfied that it is illegal for physicians to strike even as hospital employees, while nurses can go right ahead and essentially shut those same hospitals down. Many are unsatisfied with the state of tort reform. Many do nothing but complain about it over coffee or on a thread seen by a mere 100 people.

What is the alternative? Strive to do something about it.

But, you're "only a pre-med". So what. Show support and get involved. That attitude can propagate perpetually, "I'm only a med student, let the residents get involved", "I'm only a resident, let the attendings get involved", "I'm an old attending, let the younger generation get involved".

Tomorrow, tomorrow... Why not today?

You know what 25,000 supporters for a healthcare petition gets you with the AMA? Heard. You know what 25,000 supporters for a healthcare petition gets you with the White House? Answered. You know what 25,000 supporters for a healthcare petition gets you with the internet? Viral. You know what 25,000 supporters for a healthcare petition gets you with the news media? Front page.

You know what "writing a letter to your congressman" gets you? Exactly where we are currently -- swept under the rug.

 

[dbeast]

I think this is a great idea as long as we solely focus our discussions on how URM's have it easy and why anyone would choose DO over MD.

 

[Chip N Sawbones]

Because nobody here thinks.

 

[911 Turbo]

I think this is a great idea as long as we solely focus our discussions on how URM's have it easy and why anyone would choose DO over MD.

 

[487806]

Well, we do have very intellectual people on SDN, but they are all busy focusing on medical school, residency, and their job at the hospital. Premeds aren't the best candidate for the job.

 

[Frazier]

Well, we do have very intellectual people on SDN, but they are all busy focusing on medical school, residency, and their job at the hospital. Premeds aren't the best candidate for the job.

I'm going to have to agree with you -- "Premeds aren't the best candidate for the job."

However, premeds become med students, med students become residents, residents become attendings. And so it goes.

Never too late to become involved.

 

[487806]

I'm going to have to agree with you -- "Premeds aren't the best candidate for the job."

However, premeds become med students, med students become residents, residents become attendings. And so it goes.

Never too late to become involved.

Right, but only few premeds become med students. Once the premeds are accepted somewhere and will matriculate after the cycle ends, they are qualified for the job.

 

[Frazier]

Right, but only few premeds become med students. Once the premeds are accepted somewhere and will matriculate after the cycle ends, they are qualified for the job.

Yes.

 

[gutonc]

Do you live in Washington?

 

[Frazier]

Do you live in Washington?

Not I...

Is it safe to say that you would be in favor of the 'physicians for legalization' campaign?

 

[Jas1360]

Well, we do have very intellectual people on SDN, but they are all busy focusing on medical school, residency, and their job at the hospital. Premeds aren't the best candidate for the job.

What good is all that training if all the most qualified and intelligent people are too busy to come together to figure out better solutions for the future of medicine? Should we really just allow the politicians to figure it all out for us?

 

[Spinach Dip]

Good idea.

First thing we should do is redesign the MCAT so it can actually be used as 1)a representative measure of someone's academic capabilities and 2)a reasonable indication of how they'll perform in med school.



(I'm looking at you, Verbal Reasoning, Writing Sample, and Upcoming Behavioral Sciences sections!)

 

[Frazier]

What good is all that training if all the most qualified and intelligent people are too busy to come together to figure out better solutions for the future of medicine? Should we really just allow the politicians to figure it all out for us?

Hear, hear!

 

[phikapdoctor]

Good idea.

First thing we should do is redesign the MCAT so it can actually be used as 1)a representative measure of someone's academic capabilities and 2)a reasonable indication of how they'll perform in med school.



(I'm looking at you, Verbal Reasoning, Writing Sample, and Upcoming Behavioral Sciences sections!)

2015 change? Where have you been? Still not a reasonable gauge however.


Sent from my iPhone using SDN Mobile app please excuse punctuation and spelling

 

[Narmerguy]

What good is all that training if all the most qualified and intelligent people are too busy to come together to figure out better solutions for the future of medicine? Should we really just allow the politicians to figure it all out for us?

I actually think this is a cool idea, but you have to consider the type of people you're talking about here. The ones that are action-oriented and willing to actually give a significant portion of their time are likely already seeking out positions of influence. These jobs are demanding and there's not a lot of time or incentive to invest in a small thinktank startup.

 

[Spinach Dip]

2015 change? Where have you been? Still not a reasonable gauge however.

LOL?

I was saying those sections are exactly what I have the biggest problem with.

 

[phikapdoctor]

LOL?

I was saying those sections are exactly what I have the biggest problem with.

Ahh I read wrong, it's 1:40..


Sent from my iPhone using SDN Mobile app please excuse punctuation and spelling

 

[Frazier]

I actually think this is a cool idea, but you have to consider the type of people you're talking about here. The ones that are action-oriented and willing to actually give a significant portion of their time are likely already seeking out positions of influence. These jobs are demanding and there's not a lot of time or incentive to invest in a small thinktank startup.

Heh, I knew I could count on you to chime in on this. 😀

What you say makes perfect sense... those that would be interested are likely already seeking out positions of influence. But, the question then becomes: what's available to them? ...Local AMA chapters? ...Nonuniform med school interest groups? Ah, there are those that have made the full jump into politics, but therein lies the rub -- they are no longer healthcare professionals, but, rather, politicians.

Politicians cater to public opinion (and we are in dire straits when it comes to that). Public awareness. Outreach. We need to be heard at some point.

In regards to the time requirements/incentives, you're right on the mark. It might appear as not the best cost:benefit ratio. But, is that the long term reality? We don't know what beneficial impact we might have down the road (and I know that I don't need to explain the intangible reward of fighting for a cause/change).

In regards to time requirements, therein lies part of the beauty of SDN's magnitude. Similar to how the moderator staff is beefed up to accommodate demand and certain forums get extra-beefed up to divide the work among the mods to comfortably-manageable amounts, I believe the same could be done with the Think Tank. Build the numbers, diversify the experts/senior fellows/student fellows/physician innovators/whatever-noun-is-decided-upon across the topics and expand at a comfortable pace. Set comfortable benchmarks that will push the cause, but not any single person to their limits. As with many things that revolve around humans, once it gets going, growth could occur exponentially.

As you alluded to, marching on Washington might not be in the cards for day #1 😉 , but who knows. With enough time and by taking advantage of consistent growth from an initially humble presence.... Well, I imagine it can only be an improvement over what we have now as med students/residents/fellows/attendings.

 

[eefen]

I would definitely be interested in something like this. I'm only a "premed" now, but come this fall I will be a medical student...and then a resident....and then an attending. I have a strong interest in health policy, and will likely get involved at some point along the road. Something like this would be awesome. Physicians as a whole, I think, tend to do a poor job of representing themselves politically, and then get subjected to laws and policies that make no sense to a provider who is practicing "in the trenches," as it were, but might make sense to a number-crunching, paper-pushing administrator.

I propose that our first target should be patient satisfaction scores and their increasing role in reimbursement--particularly for specialties like EM, this makes absolutely no sense. Or perhaps tort reform...that's another area that nonsensicality reigns. Both of these are messy areas that negatively affect how medicine is practiced.

 

[ijn]

Future doctors don't need additional government subsidies for their loan interest. Come the feck on. We have to make big spending cuts for the sake of our country. Earners in the top 5% don't need more breaks.

 

[MCAT guy]

Future doctors don't need additional government subsidies for their loan interest. Come the feck on. We have to make big spending cuts for the sake of our country. Earners in the top 5% don't need more breaks.

2 comments, the only way this would work would be REAL names and real people, not sdn accounts and online personas.

Next, I agree that the top 5% of earners probably don't need tons of help. But what I think could be a big priority is dealing with tort reform. Its crazy that you can get a 10 motion at lawsuit slapped on you. There must be sensible caps.

I think you are all smart enough to get things done. Its inability to work as a team and arrogance that will impede progress.

 

[link2swim06]

Future doctors don't need additional government subsidies for their loan interest. Come the feck on. We have to make big spending cuts for the sake of our country. Earners in the top 5% don't need more breaks.

But do nurse anesthetist need to be paid more than PCPs?

 

[Winged Scapula]

Moving to Topics in Healthcare

 

[GlowInTheDark]

2 comments, the only way this would work would be REAL names and real people, not sdn accounts and online personas.

I think the only people would fear their real identity being known are those that constantly insult and badger people as a result of their keyboard courage. I'm sure there are plenty of users that aren't worried about the things they have posted biting them in the butt.

I'd graciously exchange anonymity for cooperation to tell the "know-nothings" in DC what the real implications are for the decisions they make.

 

[Frazier]

Future doctors don't need additional government subsidies for their loan interest. Come the feck on. We have to make big spending cuts for the sake of our country. Earners in the top 5% don't need more breaks.

You would obviously not support that issue then...which is perfectly fine. However, more so than simply seeking "additional subsidies from the government for their loans" it is an issue with reverting back to what the medical school loan system was for quite awhile (staffords were subsidized, rates were well < 4%). The government isn't exactly doing charity work for us, it is 6.8% on nondischargeable debt -- ironically, loaned to people that will be able to pay it down without major difficulty. I can buy a car and XYZ other trinket at a lower interest rate -- that's riskier and dischargeable. My CREDIT CARD has a lower rate than the Grad Plus loans! That is ridiculous.

Now, with that said, is there any facet of your future profession that you have an interest in being proactive about?

2 comments, the only way this would work would be REAL names and real people, not sdn accounts and online personas.

Next, I agree that the top 5% of earners probably don't need tons of help. But what I think could be a big priority is dealing with tort reform. Its crazy that you can get a 10 motion at lawsuit slapped on you. There must be sensible caps.

I think you are all smart enough to get things done. Its inability to work as a team and arrogance that will impede progress.

I 100% agree with your first point... "A call for meaningful tort reform in the United States healthcare system. By: MCAT guy" haha, it doesn't carry a lot of credibility.

How the issue of real identities could be handled on SDN are numerous. Perhaps some people like NickNaylor and mmcdowe have no problems with revealing their true identities to the greater SDN crowd; however, I imagine others appreciate their anonymity when it comes to the actual forum posting. Perhaps SDN could permit those involved in the Think Tank the option to have 2 accounts (a "business" account [real name, transparency, etc.] and a your typical anonymous SDN account). This is done often (people having alt accounts), however it is currently against TOS. So SDN would have to implement a permission for those with sincere need.

Also, I agree with your opinion on tort reform. I think that the way these cases are tried in our courts needs to be revised. Instead of malpractice cases being determined by a jury of pure laymen, those often easily manipulated by the emotional appeals of lawyers, I believe that other physicians and healthcare professionals are more qualified to determine if a peer was negligent or in some other way "guilty" of malpractice. I can't help but shake my head when an OBGYN is smacked with a multi-million dollar verdict for a bad outcome despite doing everything "by the books and followed medicine's best practices". Why? Because a layperson sitting in the jury box often can't appreciate that fact. I'm sure the plaintiff's lawyer did his best to ensure that be the case when picking jury members. What the jury does appreciate is crying mothers, devastated families, and oscar-worthy performances by trial lawyers.

I think the only people would fear their real identity being known are those that constantly insult and badger people as a result of their keyboard courage. I'm sure there are plenty of users that aren't worried about the things they have posted biting them in the butt.

I'd graciously exchange anonymity for cooperation to tell the "know-nothings" in DC what the real implications are for the decisions they make.

👍

 

[Frazier]

Isn't that where threads are sent to die?

Hmm, first page has a thread posted all the way back in May.

...Yep, looks that way.

 

[Winged Scapula]

This thread has been cross-posted in multiple forums; this one will be closed. Those wishing to continue the discussion can do so in the TIH forum.

 

[GlowInTheDark]

Future doctors don't need additional government subsidies for their loan interest. Come the feck on. We have to make big spending cuts for the sake of our country. Earners in the top 5% don't need more breaks.

Fine, don't fully subsidize it, charge interest that will keep up with inflation so the govt. will break even. If origination fees don't cover administrative costs then either: a) be more efficeint or b) since a) is impossible b/c we are talking about govt. here, raise the origination costs.

The govt. profiting off your education is what is absurd.

I'm curious to see the tune that many of us will be singing about taxes when we are in the top 5% instead of the bottom of the bottom.

 

[Winged Scapula]

Isn't that where threads are sent to die?

Not at all.

But as a former staff member, you surely know the rules about posting. This is not a topic about residency or about getting into medical school; therefore, this forum is the best place for it. Your desire to have it in a more well trafficked forum does not trump the Terms of Service.

 

[IWillChangeHC]

Blais, bravo on a great idea. I've been skimming this post and haven't had the ability to put in due diligence (I promise I will tonight or Saturday).

As someone mentioned generating action takes time. Large groups take an endless amount of time to get the wheels rolling. Yet, it's ideas like this that disrupt the entire system. This is how we can make changes in this antiquated system we call healthcare.

I'm a start-up focusing on the business side of healthcare and educating existing and future healthcare professionals about such. It's an open discussion, brain trust contributed from thought-leaders. At surface-level, I would be excited to champion such a movement. I know I only have a few posts, but I have been a long-time follower of SDN.

I don't know the ins and outs of this being under SDN, but I have the infrastructure, a growing readership of existing professionals. I'm not trying to take a way resources away from SDN, but I'm also a person of action and I think this idea has tremendous amount of upward mobility.

Perhaps a few of us that are interested in this venture can video chat here shortly and develop some ideas/movement. Blais, I would definitely like to hear more about your idea.