Doing More with Off-Label Drug Use

Patient-centered healthcare has seen positive results in off-label drug prescribing. Now’s the time to get serious about documenting off-label use in medicine.

Aug 01, 2016 - Guest Author


This article is contributed by Doximity Fellow and medical student Piyush Sharma

Research and innovation are two lasting pillars of medicine. This is clearly the case in drug development, as we watch for the newest medication to break onto the scene and change how we care for patients. But there’s more to drug treatment than simply applying the latest FDA-approved chemical. Trends over the past decade have shown that physicians are increasingly prescribing treatments off label. This type of prescribing has tremendous potential to affect how we treat patients, so why don’t we monitor and study off-label drug use (OLDU) more effectively?

Patients using drugs for unindicated purposes aren’t part of clinical trials. But that doesn’t mean we can’t learn from them. Monitoring and analyzing off-label use, its side effects, and which type of patients do well on a drug is a novel form of clinical research -- an experimental study of drugs already on the market.

AN EXAMPLE IN DERMATOLOGY
A prime example of effective OLDU can be seen with the skin disease vitiligo (a disease I happen to have). Currently, tacrolimus is designated for the treatment of eczema and not as a first-line treatment for vitiligo. However, off label, tacrolimus has shown great results in vitiligo patients. Yet, patients haven’t been educated about this additional option. Information on the drug’s effectiveness isn’t readily available to physicians. After years of unsuccessful vitiligo treatment, I found tacrolimus to be immensely beneficial in my treatment and maintenance of outbreaks. We should be doing more to see if others can reap that benefit.

Physician records of tacrolimus (and any other OLDU drug) could provide the FDA with data on populations that have benefited from the alternative use of market-approved drugs. With enough data, drugs deemed safe and beneficial for unindicated diseases could go through an expedited FDA approval process for additional uses.

HOW IT CAN WORK
The most efficient way to monitor, record, and track OLDU is through EMRs. We could use the system to mark prescriptions “OLDU,” use the database to document their success, and share the information with others. In medicine, percentages and numbers speak volumes. Providing OLDU candidates with stats on successfully treated patients can help them understand the process.

A collection of OLDU statistics would allow physicians to know how often a medication is prescribed off label and help them determine if it could benefit a patient. This type of data is crucial not only to current disease prognosis but to future treatment as well.

Monitoring OLDU, in association with data collection and analysis, provides significant opportunity. It could reduce risk in hospitals, inform current and future patient treatment, and provide a foundation for medico-legal issues that may stem from drugs being prescribed off label.

OLDU hasn’t spent much time under the microscope for fear of bringing attention to what some may consider drug misuse. But, working with available therapies may be one of the safest ways a physician can experiment with treatments. It also helps to skirt the high costs new drug development.

OBSTACLES & LIABILITY
Of course, OLDU is not without its barriers. Physicians who prescribe off label subject themselves to liability. If an OLDU treatment doesn’t work, the responsibility falls squarely on the physician’s shoulders. Physicians must justify the use of a drug and its dosage in a particular scenario, which is a challenge without guidelines. To deal with this, some OLDU prescribers start small and increase the dosage gradually if the treatment works.

The current OLDU set-up will need to be adjusted. In order to maximize a standardized OLDU database, physicians must initiate a low dosage regimen and record any adverse effects thoroughly. Once an off-label treatment is deemed successful, those results can be repeated with high internal validity.

USING THE TOOLS WE HAVE
New epidemics spread rapidly, and testing and approving experimental drugs takes up vital time. Why not use drugs that have already gone through regulatory vigilance? Environmental influences, population dynamics, and other factors change over the course of time it takes the FDA to approve a drug for a disease. By using EMRs to implement OLDU databases, we can take positive steps to provide safe and effective treatment options more quickly.

Let’s make more of what we have. It’s time.

Disclaimer: The views and opinions expressed here are solely those of the author and do not necessarily represent Doximity’s views.

When are physicians most likely to meet their co-authors?

Since research and co-authorship are so important, it’s worth wondering: When are doctors most likely to meet their co-authors? And how do they shape our trajectory in academia?

Jul 11, 2016 - Guest Author


This article is contributed by Dr. Mahboob Alam, Doximity Fellow and Assistant Professor of Medicine-Cardiology at Baylor College of Medicine

In medicine, expressing our thoughts and findings in the form of research papers is of utmost importance. Our research helps spread knowledge and may both directly and indirectly impact patient care. Through published research, we learn from each other’s experiences -- whether the outcomes are desired or adverse.

When writing papers, our co-authors are a vital source of ideas and support. Writing a manuscript and getting it through the rigorous process of peer review and publication can be painstaking. Co-authors are closely involved with manuscript from the beginning, and they’re the best peer reviewers one can have. I’ve been fortunate to work with co-authors who are well known in academic medicine. They were essential to our papers’ successes and made each one better, which ultimately led to faster publication.

Since research and co-authorship are so important, it’s worth wondering: When are doctors most likely to meet their co-authors? And how do they shape our trajectory in academia? To find out, let’s take a look at some data.

According to new Doximity research, 60% of co-authors who trained together first did so in residency training. Of the rest, 20% were medical school classmates, 18.5% met during fellowship, and 1.5% met during internship.

This data highlights an important fact about our training as physicians and the paths we take as we advance in our careers. Internship is an extremely busy year of one’s training and, more so, it’s a critical year in which we lay the foundations for our future in clinical medicine.

Based on my personal experience, I was least productive in terms of writing papers during my internship year. This was mostly due to extended work-hours and call schedules. Despite the fact that 20% of my classmates from intern year ended up in the same specialty (cardiovascular medicine), I hardly remember collaborating with one of my co-interns on a research paper or a project. Internship year, however, helped me plan for the future. It also helped me meet seniors and faculty members who were actively engaged in clinical research and who would later become my co-authors.

As I write this, our new interns have recently started and finished their orientation week. The year ahead is going to be a busy one, and the race towards excellence in academic medicine starts on day one. Identifying your co-authors starts right away too! Remember, there’s a high probability you’ll meet your co-authors early in your career. It all starts with an idea that blossoms into a research abstract and ultimately, with the help of right minds, into an outstanding research publication.

How Does Your Name Stack Up Against the Top NP Names?

Doximity explores the most popular names for nurse practitioners

Jun 22, 2016 - Sarah Lemas


As the co-founder of the first nurse practitioner program in the U.S., Dr. Loretta Ford is often referred to as the mother of the NP movement. And while her name will live on in NP history books, we wanted to know if the name “Loretta” literally carries on among the ranks of today’s NPs. To find out, we searched across NP names in the U.S. to see what naming trends we could uncover.

Where have all the Loretta’s gone?

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The most popular female first name overall among NPs is Jennifer, followed very closely by Mary. Whether you are named Jennifer or Mary probably depends on your age. The average age for a NP in the United States is 49. Mary was the most popular name in the 1940’s-1960’s, while Jennifer rose to popularity in the 1970’s-1980’s.

For male NPs, Michael is the most popular by a wide margin, with David, James & John in a dead heat for second place. Interestingly, this does not quite match the lineup of Doximity’s recap of most popular doctor names, where John commands the winning spot. This may be because the average male doctor is 55, which is six years older than the average NP. John has been a popular male name for more than 100 years, especially in the 1940’s-60’s. By contrast, Michael achieved especially strong popularity in the 1970’s, 80’s and 90’s, when many current NPs were born.

The state of a name

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The state trends follow the overall nationwide naming trends. Jennifer is the number one female NP name in 26 states. It is followed closely by Mary, which wins in 19 states. And in fact, if you look at the number of states where a name is ranked either #1, 2 or 3, Mary slightly edges out Jennifer, 46 states to 43. With two names that are both so popular, it’s hard to discern strong regional trends. Jennifer seems to be slightly more popular in the South and West, while Mary is pretty evenly spread across the country. The stronghold for the name Susan is in the Northeast, and Patricia makes its lone appearance in the #1 spot in New York State.

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Michael tops male NP name in 25 states. David, James and John trail behind as distant runners-up, with only 7-8 states each. Michael dominates the Northeast and Midwest. David is strongest in the Northwest, while James does best in the South. There are also a couple of interesting anomalies here and there, such as Frank being the fourth most popular name in Delaware, but it doesn’t make the top 5 list in any other state. Similarly, Jeffrey is ranked #4 in North Dakota, but no other state seems to have a significant NP population with that name.

What’s your speciality, NP So-and-so?

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Among female NPs, the popular names for most NP specialities match the overall ranking. For example, for acute care, family NPs and psychiatric NPs, the most popular names are Jennifer and Susan. But there are a few specialities which buck the trend. For example, among geriatric NPs, while Mary is the most popular, Linda is also a common name, which suggests that many geriatric NPs were born in the 1940’s and 50’s, when Linda was most prevalent. On the other hand, Karen stands out as third among neonatal NPs, a name that had its heyday in 1960’s.

Male NP names by specialty match the overall popularity for the most part. Michael and David are top names for geriatric, neonatal and family NPs, and they are also in the top five for most other specialities. Christopher makes an appearance as a popular name for acute care NPs, and James is on the list for psychiatric NPs.

Will the real NP please stand up?

When we look at the most popular last names across all NPs, Smith and Johnson reign supreme. Miller, Brown and Williams are on the list as well. Smith is slightly less common in the Northeast and West, while Johnson has the lead in the South. These are also the most common surnames in the United States as a whole.

What’s your name?
How does your name stack up against the most popular nurse practitioner names? The odds suggest your name probably isn’t Loretta Ford but it might be Jennifer Smith or Michael Johnson. What’s your prediction on what new names will start to trend among NPs in the next 5-10 years?

Do you know any of these Jennifers or Michaels? Claim your profile and find out: www.doximity.com.

Prominence among your peers

Tips to grow your professional clout

Jun 16, 2016 - Tim Horvat


Would you like to be considered an expert among your peers?  Or maybe you’d like to get some mainstream press coverage?  We took a look at the CV’s of a number of media-savvy physicians, to glean some tips on how you can increase your professional clout.

1. Take advantage of opportunities that showcase your expertise.  Dr. Jonathan LaPook, the chief medical correspondent for CBS, is a well regarded gastroenterologist whose first media experience was doing an on-screen colonoscopy on Katie Couric.  He got the job at CBS a few years later when the network decided that they wanted a practicing physician (instead of a journalist) as their new medical correspondent, because it would help ensure they were authoritative and up-to-date on the latest medical advances and patient concerns.  

Similarly, Dr. Manny Alvarez, the senior medical news editor for Fox News, completed two residencies and two fellowships. He’s also a professor and currently serves as chair of the OB/GYN department at the Hackensack University Medical Center in New Jersey. He got his start in TV doing a small segment for Telemundo.  Dr. Jennifer Berman, who co-hosts The Doctors and has appeared on Good Morning America and other shows, is one of the country’s leading experts on women’s sexual health issues.  Among her many achievements, she co-founded and served as director of the Female Sexual Medicine Center at UCLA.  She spent years establishing her medical credentials before she became famous. And they are not alone: almost all of the medical correspondents on TV and major newspapers are respected practicing physicians who see patients in addition to their media work.  

2. Write for the mainstream press.  One way to gain prominence is through writing and publishing for the general population.  Pediatrician Dr. Wendy Sue Swanson, who is best known for her Seattle Mama Doc blog, recognized the importance of social media early on. With her help, Seattle Children’s Hospital became the first major children’s hospital to have a pediatrician-authored blog.  Her widely-read blog led to speaking engagements and other media opportunities, including a position on the board of advisors for Parents Magazine, TV appearances, a Huffington Post blog, and becoming an official spokesperson for the American Academy of Pediatrics.

Dr. Sanjay Gupta, neurosurgeon, author, and CNN’s chief medical correspondent, started writing articles for small magazines and newspapers as an undergrad.  The more he wrote, the bigger the magazines and newspapers became, which began to broaden his thinking about how to approach his career.  As he said in a story on Guideposts.com, “If I could help a patient one-on-one in a doctor’s office, think how many more I could reach with a story about a promising new cancer treatment or information on preventive medicine.”  Reaching this broader audience via writing raised his public profile, which contributed to his popularity.

3. Consider politics.  Political involvement is another way to establish your credibility.  For example, Dr. Atul Gawande, the surgeon, author & health policy scholar, volunteered for a variety of political campaigns starting as an undergrad, including working for Gary Hart and Al Gore.  He took a break from med school to be Bill Clinton’s healthcare lieutenant in the 1992 campaign, and eventually he became a senior advisor in the Department of Health & Human Services, before returning to finish his medical degree. This political work, along with his writing for Slate and The New Yorker magazine, helped place him in the public eye.

Dr. Sanjay Gupta also has political experience on his CV.  In 1997, Gupta was selected as one of fifteen White House Fellows. During the year-long fellowship, he wrote healthcare speeches for then first lady Hillary Clinton.  This built up his public reputation as a medical expert and created connections.  It’s where he first met the CEO of CNN, Tom Johnson, who later invited him to join CNN’s new medical division as an on-air correspondent.

4. Develop your brand.  Public exposure in one medium often leads to more publicity.  Dr. Travis Stork got his big TV break when he was chosen to star in Season 8 of The Bachelor while he was still a resident, by a chance meeting at a bar of someone who worked on the show.  And then when they started to cast the first season of The Doctors, the producers looked specifically for licensed practitioners who already had television experience. 

A more pragmatic path to TV opportunities is that of Dr. Nancy Snyderman. She spent 15 years as chief medical editor for NBC, but she got her broadcast journalism start doing small appearances at the ABC local affiliate in Little Rock, shortly after she joined the surgical staff at University of Arkansas.  Starting small with a local broadcast channel eventually led to bigger & better media opportunities.  

Physicians can also acquire a following online.  Dr. Sandra Lee, a California dermatologist known on the Internet as Dr. Pimple Popper, started with a personal Instagram account two years ago.  She noticed that her most popular posts were of her at work, popping pimples, blackheads and cysts.  She realized there might be a market for this kind of content, so she created a YouTube channel of herself performing these extractions.  At last count, she had more than one million YouTube subscribers, and her videos had more than 570 million views.  This wild popularity has led to multiple magazine articles and online media coverage as well as TV appearances.  

Do you want your expertise to be widely known?  If so, start by establishing yourself as a knowledgeable physician in your field and get your name out there, in print, online or on TV.  Once you build some public exposure, you may be able to leverage it into additional opportunities.

Anyone can get started by establishing his or her professional reputation online. This means using social and professional networks to control your brand. Doximity gives members the power to showcase their backgrounds, accomplishments, and overall expertise in one easy-to-use national directory. If you haven’t already, create a profile and begin cultivating your professional profile.

Best Conference Presentations on Social Media in Healthcare

As social media use among medical professionals continues to climb, we’ve also seen an uptick in discussions on the topic at medical conferences.

May 31, 2016 - Ali Bonar


How much do you use social media for professional purposes? As social media use among medical professionals continues to climb, we’ve also seen an uptick in discussions on the topic at medical conferences. Today, we are highlighting some of the most interesting conference presentations on the use of social media in the healthcare community.

1. Social Media for the Surgeon: Lifelong Learning, Engagement, and Reputation Management

Dr. Deanna Attai, 2016 American College of Surgeons Leadership and Advocacy Summit


Dr. Deanna Attai, a breast surgeon at the David Geffen School of Medicine at UCLA, gave this talk at the 2016 American College of Surgeons Leadership and Advocacy Summit in April. Dr. Attai includes step-by-step how-to’s on getting started with social media as a doctor, and shares these words to live by online: “Don’t lie, don’t pry, don’t cheat, can’t delete, don’t steal, don’t reveal.”

2. Residency and Social Media: Triple Threat or Triple Promise (Allegheny Health Network)

Dr. Joan Devine, Dr. James B. Reilly, Dr. Abirami Janakiraman, Dr. Nicole Sacca, 2016 Association of Program Directors in Internal Medicine Annual Meeting

This presentation was given at the 2016 APDIM Chief Resident Meeting in April, by four doctors on the faculty of the Allegheny Health Network residency program in Pittsburgh: Dr. Joan Devine, Dr. James B. Reilly, Dr. Abirami Janakiraman, and Dr. Nicole Sacca. They explore both the benefits and pitfalls of social media, especially for medical residents, as they travel the road from student to doctor. The presentation includes basic rules of engagement to build a truly professional presence online, as well as how to avoid HIPAA violations.

3. Time for Physicians to Get Social

Dr. Edward Mariano, 2015 American Society of Regional Anesthesia and Pain Medicine


At the 2015 American Society of Regional Anesthesia and Pain Medicine meeting, Stanford anesthesiologist Dr. Edward Mariano, shared a comprehensive guide on how healthcare professionals can curate and build your online reputation as a clinician, with platforms such as Doximity and Twitter. Dr. Mariano also shares actionable tips on how to leverage social media to promote and expand the reach of your published research.

4. Nurse Practitioners and Social Media: What's Your Networking IQ?

Dr. Melanie Keiffer, 2016 California Association of Nurse Practitioners Annual Education Conference


Dr. Melanie Keiffer, Associate Professor from the School of Nursing and Health Professions at the University of San Francisco, presented this talk at the California Association of Nurse Practitioners Annual Education Conference. Keiffer focuses on using social media as a tool to educate and connect with patients. She suggests using podcasts, Youtube and blogs to engage patients where they are already hanging out online.

5. The Nuts and Bolts of Social Media. AKA: How Do I Use This Stuff?

Dr. Neil U. Lall 2016 American Society of Neuroradiology Annual Meeting

Want to improve your social media presence at your annual meeting? Resident and Fellow Section Chair of the American College of Radiology Dr. Neil U. Lall has you covered, with step-by-step tips on how to effectively use Twitter, Facebook and other mediums, while still protective your privacy.

Have you learned anything recently about how you can more effectively incorporate social media into your professional life? Tweet @Doximity and let us know!

5 Must-Read Articles for Physician Assistants

Physician Assistants can help improve access to medical care, elevate health outcomes, and increase patient satisfaction.

May 19, 2016 - Tim Horvat


As a team-based approach has become the norm in the U.S. healthcare system, physician assistants have a growing role in the delivery of healthcare, becoming increasingly important members of the team, in primary care and across other specialities. PAs are crucial to many clinics and make sure patients are seen quickly, treated properly, and receive follow up care.

The PA profession was first proposed in the 1960s due to concerns about the supply of primary-care physicians, which led to the development and training of new types of direct care providers, like PAs.  In the past 25 years, the number of PA’s has grown by 5x, to more than 100,000 certified PAs in the workforce today, according to the NCCPA.  And the number of PAs is expected to continue to climb, with a projected growth rate of 30% in the next 10 years.  This is great news for the delivery of healthcare, as PAs can help improve access to medical care, elevate health outcomes, and increase patient satisfaction.   

Because of the valuable role that PAs play, and in honor of the AAPA conference this week, we wanted to share with you some of our favorite recent articles about PAs and their role in medicine today.

1. What It’s Like to Have the Best Job in America Right Now… hint: the best job is a PA, according to a report by Glassdoor!

2. When It’s OK to See A Nurse Practitioner or Physician Assistant - And When It’s Not… Explains when it might be more efficient and just as effective to see a PA or NP instead of a doctor, as well as when it makes sense to get a second opinion. 

3. 8 Things Never To Say To A Physician Assistant… all those things that drive you crazy as a PA.

4. Physician Assistant Pay Reaches $100K Annually… Good news: average PA salaries are on the rise.  This article shares some interesting salary range data, as well as which states have the highest median PA salaries.

5. The Best Medical Apps for PA Students, Physician Assistants and Medical Professionals… A helpful summary of some great medical apps you should have on your mobile device.  

Like what you see? Sign up for bi-weekly roundups of noteworthy PA news: doximity.com.

Join us for Doximity Tech Night on May 24

Confessions of a Gopher: Tech Talk by Matt Aimonetti

May 18, 2016 - Doximity Blog


We would like to invite the Bay Area software engineering community to an event and keynote by renowned technologist, entrepreneur, technical writer and active open-source contributor, Matt Aimonetti. Matt is currently CTO of cloud-based music creation and collaboration platform, Splice.

Food and drinks will be provided on Doximity's headquarters: 500 3rd Street, Suite 510, San Francisco.

Program for the Evening

6:00 - 6:30 pm | Check in and Drinks

6:30 - 7:00 pm | Matt Aimonetti, "Confessions of a Gopher"

7:00 - 9:00 pm | Food and Drinks

About The Keynote: Confessions of a Gopher

After 10 active years in the midst of the Ruby revolution I decided it was time to build my own product mixing my two passions: music and code. I made the deliberate choice to use Go for the backend. Our front-end initially written in Rails quickly migrated to JS. 3 years later, terabytes of analyzed audio files and billions of requests later, it's time to reflect on my technical choices and their consequences.

About The Speaker: Matt Aimonetti

Matt Aimonetti is the CTO and Co Founder of Splice, the cloud platform for music producers. He actively contributed to the Ruby ecosystem as technical author, speaker and members of FOSS projects such as Merb, MacRuby and Rails. Go early adopter, he built the Git of music & the rest of Splice's backend using Go. He even wrote a free Go book!

RSVP for Doximity Tech Night

Secure your spot before seats fill up!

Now accepting applications for Doximity Fellowship 2016-17

An opportunity for clincians helping select the most important medical news, kindling conversation on impactful stories

May 13, 2016 - Production Blog Author


We are pleased to announce the opening of our 2016-2017 Fellowship application. This remote fellowship is a fantastic opportunity to get involved with Doximity content by helping select the most important medical news, kindling conversation on impactful stories, and contributing to the Doximity blog.

If you’re interested in bringing content to your colleagues and have unique perspectives to share with others (not to mention earning some valuable name recognition), we’d love to hear from you.

Fellows will
  • Enjoy the opportunity to work with an elite group of medical and health IT experts
  • Build a reputation as a healthcare influencer
  • Access private beta products and premium features
  • Receive compensation in the form of equity and honorarium
  • Attend and host exclusive Doximity events
What previous Fellows have to say

As a fellow for the second consecutive year, it has been quite gratifying to watch doximity transform from a little known entity to one that is becoming an essential daily tool for many US physicians. The fellowship itself has benefited me personally in helping me stay up to date on the latest developments in my specialty of ophthalmology and the greater medical community. It has also provide a wonderful forum to interact with other colleagues, who I otherwise would not have had the opportunity to do so. Also, I have enjoyed being able to provide feedback to new features that are being developed for doximity and then seeing those features launch. I look forward to more opportunities in the future to remain involved with doximity.

Darin Goldman, MD

Interested? Apply now.

Application

The application deadline is May 30, 2016. Upon completion of the application, finalists will be invited via email to a phone interview. Please contact fellows@doximity.com with any questions.

What 5 clinicians think about the Joint Commission’s new stance on texting

"Finally, physicians can move beyond the pager and start embracing secure technology in communicating orders"

May 10, 2016 - Doximity Blog


As most healthcare providers already know, the Joint Commission just lifted its ban on texting orders (with caveats). Here at Doximity, we’re supportive of this movement in policy especially as it’s aligned with our own mission: to connect all U.S. clinicians to each other in order to enhance communication and improve their daily workflow. We asked five Doximity members what they think about the Joint Commission’s new stance on texting:

"In a time when most physician offices and hospitals have electronic medical records, and almost all physicians communicate with each other and with patients digitally, texting is simply the next logical step in physician-to-physician communication. With measures to ensure secure and confidential information, texting can enhance patient care. It can provide faster answers to patient questions, ensure faster referrals, and offer peer-to-peer advice."

-Kristin Sokol, MD, MS, MPH
Instructor, Department of Allergy and Inflammation
Beth Israel Deaconess Medical Center

"I think texting orders are a great idea because verbal orders can be misunderstood at times and we deal with bad phone connections at times with skipping of parts of the conversation."

-Rodney Samaan, MD
Founder
ProgressiveMD

"Wow! This could really have a positive impact on care. I think of my colleagues on the outpatient team. They field calls and make care adjustments while on the road. The ability to text an order to pharmacy could present a rapid way to impact care. I could envision an NP meeting with family and dictating to text prescription orders and changes as they come up. At the end of the visit, check the text, and the number, send. A realtime way to eliminate the phrase, 'I forgot to order that.'"

-Craig Durie, NP
Family Nurse Practitioner

"Finally, physicians can move beyond the pager and start embracing secure technology in communicating orders. This should go a long way in improving patient care as well as workflow for physicians."

-Armand Krikorian, MD
Program Director, Internal Medicine Residency Program
Advocate Christ Medical Center

"I applaud the Joint Commission's new stance to lift the ban on texting orders. This will enable providers to improve care for patients by reducing length of stay‎, without leading to an increase in rates of readmission. This was demonstrated in a recent study published in the Journal of General Internal Medicine. The University of Pennsylvania study examined over 11,000 patients in two separate hospitals. One hospital adopted secure text messaging, switching from a standard paging system, reducing length of stay (LOS) from / to 5.4 days within a month's time. The other hospital continued to use its standard paging system, and noted no change in length of stay. In making the transition to texting orders as well as other provider-to-staff communication, it's vital that health care systems have policies in place to record and document texts electronically or manually in the electronic health record (EHR). Some EHRs have built-in and secure platforms for texting, which allow integration of the received texts. However, there are still many that don't, making this an important area to place attention when adopting the new policy change to integrate texting for communication."

-Robert Glatter, MD
Attending Physician, Emergency Medicine
Lenox Hill Hospital

How do doctors keep up with the latest literature?

Physicians work hard to stay current on best practices to help optimize patient outcomes

May 05, 2016 - Production Blog Author


by Natasha Singh, Doximity

In the past we have shared information on how physicians read the news and have explored trends in how millennials and older physicians get their news. We developed these insights from data gathered from aggregate user behavior on Doximity as well as a survey of Doximity members. Today, we wanted to continue this series with a few additional insights on how different specialties keep up on their medical reading.

How much does medical literature matter? A lot.

To recap our findings from previous research, our survey found that 75 percent of physicians change their clinical practices quarterly or monthly based on reading medical literature. Perhaps unsurprisingly, 98 percent of physicians reported reading medical literature is important or very important to their practice.

Mobile vs. laptop?

There are a few interesting differences in how various specialties get their news delivered. Overall, more than two-thirds of physicians catch up on medical news on their mobile device vs. their laptop. But specialties such as neurosurgery, cardiology and orthopaedic surgery are among the most likely to access their news from their phone or tablet, while they are on the go. On the other hand, pathologists and immunologists, are 35% more likely than the average specialist to get their news on their computer. We suspect it has something to do with the countless hours spent in the lab.

What are they reading?

The average Doximity user is reading two or three articles every week posted on Doximity, from medical journals as well as other sources. Neonatologists, thoracic surgeons and emergency medicine physicians tend to be the heaviest weekly readers overall. However, radiation oncologists and neurosurgeons read more scientific and medical journal articles versus other medical news, as compared to other specialties. Generalizing, there seems to be a trend toward more highly specialized clinicians reading more scientific and technical articles, while general practitioners are more likely to take interest in healthcare related articles their patients may be reading in the lay press. By staying up-to-date on mainstream topics, general practitioners are better prepared to discuss the health topic du jour when brought up by patients in their office.

All the news that’s fit to print

It is time consuming to keep up with the latest medical advances, but physicians work hard to stay current on best practices to help optimize patient outcomes. Depending on the demands of your specialty and your practice, you probably have developed your own habits on how to stay current on medical literature.

What do you find to be the most effective ways to keep up with medical literature? Tweet @Doximity and let us know!