Lee Schwamm, Vice Chair of Neurology from Mass General Hospital on designing effective approaches to patient care

It is a great pleasure for me to welcome Dr. Lee Schwamm, Professor of Neurology from Harvard Medical School, Vice Chair of Neurology from Mass General Hospital (MGH) to the feisworld podcast. Growing up in China, many kids such as myself had an obsession with the medical field. Only later I learned that I didn’t have what it took to become a doctor. Nearly ten years into my career, I still find myself desperately wanting to know more and understand what it is that makes doctors into who they are, and how they can do what they do.

In this one-hour interview, Lee talks with me about a Day in the Life of a Neurologist at MGH, followed by a 20-min deep dive into the study and evolution of patient care and patient satisfaction. What are some of the more straightforward vs. ambiguous measurements in patient care? Consider these domains: 1) measurements of doctors' intentions, 2) whether or not their intentions match the patients’ wishes, or 3) by the outcomes themselves, or 4) by the procedures doctors recommend.

If you can’t see the media player controls above, here are other ways to listen:

Some of you may already be thinking about crowdsourcing. But in this case, does the crowd know best? What exactly are the values people look for in a doctor, or in a hospital?

In the second half of this interview, I time traveled with Lee back to when he was still in college. What was Lee’s secret origin story that shaped him into who he is today? Get ready Lee’s point of view on robotic surgery, social network analysis, bringing technology into healthcare.

Here are some of the themes mentioned & questions asked during my interview:

Part 1 [First 30 mins of the interview]: 

  • A Day in the Life of Lee Schwamm
  • The study and evolution of patient care and patient satisfaction
  • What are some of the more straightforward vs. ambiguous measurements in patient care?
  • Why some doctors believe that it is a terrible idea for the "crowd" to rate the doctors? Does the "crowd" know best in this case?
  • What does a General Hospital do and the constraints it has to work with?
  • How do people select hospitals based on the information they are given? (What's the impact of one angry rant?)
  • What are the values people look for in a doctor?

Part 2 [Second 30 mins of the interview]: 

  • Lee's secret origin stories
  • The 2 Reasons as to why Lee moved away from Philosophy into Medicine while an undergrad
  • "The undivided attention and compassion for my patients"
  • People are willing to make tradeoffs for lower risk medical care
  • How has medicine changed over time? In particular, how has technology served as an asset vs. a liability?
  • "How can you be certain?" and what’s the price of certainty in medicine?
  • The result of generalizing diagnostic and therapeutic procedure far beyond those who were originally studied (problem isn’t with technology, but how we apply them)
  • Robotic surgery - Lee's thoughts on cost effectiveness and incremental utility
  • Imperial observation vs. mechanism to see who can provide good care
  • Social network analysis and impact on non-infectious diseases (density, statistical methods to compare features, etc.) Ref: Nicolas A. Christakis
  • Why is it important to be well networked and informed as a doctor?
  • What are the right skill sets for someone to manage other people for the right product?
    • Products used by tech experts vs. non-tech people
  • Lee as a project leader: "when it comes to bringing technology into healthcare, my special skill is to act like a user."

To learn more about Lee Schwamm, you can check out his medical publications, or follow him on Twitter.

Here is one news articles I found fascinating: Woman suffered stroke 35K feet above Atlantic Ocean:

"The whole paradigm has changed," Dr. Lee Schwamm, director of Stroke Services at Massachusetts General Hospital said. "Now we know 'time is brain,' or so we say. Every second counts because while the brain is deprived of blood, millions of nerve cells are dying every minute."

"Thirteen minutes from the time the stretcher entered Mass General, she had already gotten a CAT scan, bloodwork and was getting the TPA -- the clot buster," Schwamm said.

Schwamm said more and more hospitals are now training staff on how to quickly diagnose incoming stroke patients, and to try and treat them as quickly as possible because the faster doctors can restore blood flow to the brain, the more likely a patient is to recover.

After four days, doctors said Keir is 98 percent recovered.

For other news articles related to Lee Schwamm, simply Google his full name and click on "News".

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