04 April 2013

PACE 2013 Bioethics conference, day 1

I spent most of the day at an ethics conference here at the university. Let me give you a brief round up. I didn’t see everything (schedule here), but here’s a round up of some stuff I did see.

Texas cancer scandals: Panel discussion about the woes of CPRIT, a Texas cancer center supported by a state mandate to give $3 billion in research money over 10 years. CPRIT has gone from prominent hiring of Alfred Gilman, Nobel prize winning scientific advisor setting out to create world class peer review system, to grant given $18 million without scientific review, to announcing yesterday that the organizing will be closing in 60 days.

Doctor Google: This was a discussion of potential problems caused by people looking up their symptoms on Google, using cell phone apps, or other online resources rather than seeing a physician. I was surprised by two things. First, everyone in the room admitted to googling their symptoms when they felt sick. Second, the physicians are grateful for this. Both the physicians on the panel said that had changed treatments multiple times based on information that patients found in the Internet.

Freedom to be fat: The New York regulation on large soft drinks was the jumping off point for this discussion on diabetes and obesity. This one had probably the best audience participation (the timing was good to have lots of people in the room). There were a lot of different positions, ranging from “People have autonomy, full stop, and we should not do anything that interferes with that” to some people suggesting regulatory agencies did have a role to play. However, everyone’s favourite solution was “education.” I don’t think this was because it was necessarily the most effective solution, but it is one that everyone can get behind.

Open Access: I was on this panel, and readers of this blog will probably know a lot of the issues we faced. This one didn’t have a great audience participation, as not a lot of people in the room are actively publishing. One interesting moment, though, was when I asked the audience how much it cost to publish a scientific article. One medical physician, in trying to work through the problem, listed the things that would cost money. And he got to, “Paying the reviewers...”

That’s when I stopped him and asked if this was something that happened in medical journals. As far as I know, it doesn’t. Authors write for free, reviewers review for free, many editors edit for free. But it did highlight that unless you are right in the thick of scientific publishing, the issues are not clear to a lot of people.

Healthcare delivery: I got a sense of frustration out of this one. One panelist definitely was working a Tea Party vibe (“government can’t get anything right”), but there were things to learn.

One of the biggest surprises to me was the problem of electronic medical records. Now, as someone who sees nothing but benefits from digital, I was surprised that the panelists said some physicians said they’d quite or retire before dealing with electronic medical records. I asked why, and one answer was that the record keeping actually slows people down, by about 10%. Kristy Lam on Twitter described it thus:

Friends in healthcare talk about the nightmare of pop up assessments on screen. Unwinnable whackamole.

There’s also concerns about the initial cost outlay of putting in a medical record system.

External links

PACE home
UTPA kicks off annual bioethics conference (photo source)

No comments: