I've heard someone say before that medical textbooks are out of date by the time they're published.
I don't know if that's really true or not, I mean giving aspirin to chest pain patients hasn't changed since about 1980, best I can tell. BUT, even a drug with such a long history as ASA has brand-spankin' new applications EVEN THIS WEEK (Yes, this week a study was published suggesting benefit from aspirin in preeclampsia). That's kinda cool.
So, with all of this changing information, how can a provider keep up with the new and exciting things in medicine?
Good news- lots of easy, quick, and pre-digested and analyzed options out there for you!
E-mail Based Sources:
1. Physician's First Watch- This is a NEJM (New England Journal of Medicine) e-mail list that publishes headlines and brief (4 sentence or so) summaries of the article's findings. It's broken out by topic, so I subscribe to the general list, emergency medicine, cardiology, and pediatrics. You have to sign up for an account, but you don't have to pay anything to get the summary e-mails. If you want full access to their articles (which come with physician CME), you do have to pay to subscribe. I find the headlines and summaries useful, and my medical director can often get articles for me if I don't otherwise have access to them.
2. Kevin MD- This isn't so much a journal site as it is a link to medically related blogs. I use this to help keep up with the political climate, the trending issues that are less clinically related, but nonetheless key to understanding the practice of medicine (I think). It is a list of "teasers" for each of the blog posts and clickable links that take you to the website.
That gets me 3-4 e-mails per day, and I usually end up reading 2-3 articles daily on KMD, and end up researching more on a NEJM article at least weekly.
Podcasts
I have an hour drive to and from work 3 times per week. That's 6 hours of learning time I have to make use of! This is BY FAR the easiest method for me personally to keep up with the going-ons in medicine. It also has exposed me to a number of new and exciting topics, like hyperchloremic acidosis, new methods for airway management, new drugs for critical care, and some amazing clinical leadership lectures. All of these are FREE.
1. EMCrit- Scott Weingart is my hero. Dr. Weingart is an ED intensivist who talks about everything related to critical care. Not all of it is (well, perhaps most of it isn't) entirely relevant to the prehospital environment, but every podcast has me thinking about HOW I should be taking care of my patients, regardless of topic. If you listen to ANY podcasts, this should be the one! Its 20-30 min, and averages a podcast every other week.
2. Hopkins Pod-Med- Elizabeth Tracey (of Johns Hopkins) and Rick Lange (Hopkins and UTHSCSA) provide an "educated consumer" level podcast on the weekly headlines in medicine. Topics vary widely. Around 5 or so topics from journal studies are presented each week, and include a decent discussion on the limitations of each study as well as recommendations. I've learned about everything from prostate cancer screening to various types of cancers to recommendations for cholesterol drugs. Though the actual clinical topics are perhaps more pertinent to my own health (which is something I also believe in- provider health and wellness), what I think the greatest benefit of this podcast has been for me is listening to how these two really ask questions of the journal articles and discuss the limitations of each study. For this reason, I highly recommend this 20-min, weekly podcast (it comes out on Fridays).
3. Annals of Emergency Medicine Podcast- this is a summary of the studies in the monthly AEM
publication. MANY of these are relevant to prehospital care. While it's no substitute for reading the articles on your own, it is FREE, and many of us poor EMS folks who can't afford the high cost of a journal subscription can get information this way. The podcasters are a couple (I gather that they're married, though I can't confirm this), and I also believe that they're both practicing ER docs. Also can't confirm this. Each article is discussed with a particular format that involves a discussion of limitations. This podcast is good for clinical content and, as above, for the critical analysis that happens for each of the articles. It's about an hour long every month.
4. TEDTalks- this is my feel-good podcast. It's inspirational. Though it doesn't often discuss medicine, it discusses people, ideas, and some other really cool stuff. This reminds me to have heart in medicine. It's also one that makes me think about the BIG picture- why am I here? What am I doing to make the world a better place? I listened to a podcast on here the other day that talked about how to make cancer research a self-sustaining entity via a particular investment strategy. I listened to the father of Malala Yousafzai talk about his daughter, and how he became "Malala's Father," rather than Malala being "[His] Daughter." These talks are full of emotion and inspiration. And I think this podcast does a great job of reminding me WHY I have chosen medicine (albeit prehospital at the moment, but medicine nonetheless), and WHY I need to keep working hard to make the world a better place through my own talents. I have to be careful what and when I listen, though, because I'll often have (happy) tears in my eyes when I go to work if I listen to close to when I arrive! This podcast is updated often (multiple podcasts daily from recorded TEDTalks), and are anywhere from 5-30 minutes long.
Journals:
Not too many journals are dedicated to the prehospital environment. BUT there are at least two that are pertinent! I do my best to read these when they come out.
1. Prehosptial Emergency Care (PEC)- This is THE US EMS journal. Published quarterly. If you can't afford your own subscription, call your medical director and ask for his old copies. Or join an organization like NAEMT and get a discount subscription. Get your organization to subscribe. But READ THIS JOURNAL. No excuses.
2. Prehospital and Disaster Medicine- If you can get access to this, read it. At least read the abstracts! It's a British journal. This one presents a much more global view of EMS (EMS in India, Uganda, etc.). Don't forget, we're not an island here in the US- there is MUCH more to EMS than just the US!!
Well, the toddler is dragging me away, and I'm about at the end of my list. I also follow many-a-resource on facebook and twitter. But angry toddler says that social media will have to be another post!
Have a safe shift.
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DISCLAIMER: I AM NOT A DOCTOR. I hope to be one some day. Do not take any of the information on my page to be medical advice. It's not. Just because I read an article doesn't make me an expert, nor does it make you an expert, nor should you do anything the internet, any articles, or my blog say without first consulting your personal physician (yes, you SHOULD have a PCP). These are my opinions, solely my opinions, and are not the opinions of anyone else, anywhere I work or have worked, or my friends and relations. The odds of winning are so low that you should save your money and go elsewhere. Your mileage may vary. Now go forth and do good things.
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