Hey everyone, it’s Medicine Mondays… and this post is late, which seems to be happening more often lately. For that I apologize. I don’t really have a set topic to talk about today, so I’m going to talk about a few different things which are at least somewhat medicine related. So today is just “Random Medicine Musings” for Medicine Mondays.

Stock Photo from: Pixabay

The Flu

I’ve already talked about the Flu in a previous post, The Flu and You. However, I think it bares repeating that the flu is especially bad this year. Additionally, it’s important to understand that this year’s flu virus may also be airbone. This year’s flu virus is H3N2, and while the flu normally goes after the young and old, this one seems to not care. According to recent research of the current season’s flu virus:

We found that flu cases contaminated the air around them with infectious virus just by breathing, without coughing or sneezing,” said Dr. Donald Milton, who’s been studying flu transmission at the University of Maryland’s school of public health. – NBC News

He continues on to say:

Even if you are not coughing, you can still infect other people,” he added.

“Many people shedding virus into the air are shedding real, infectious virus.”

Interestingly:

The team detected influenza virus from 76 percent of the fine aerosol particles they tested and 40 percent of the coarser particles. they cultured virus from 39 percent of the fine aerosols.

“Thus, sneezing does not appear to make an important contribution to influenza virus shedding in aerosols. Sneezing might make a contribution to surface contamination,” the team wrote in their report, published in the Proceedings of the National Academy of Sciences.

Currently, the CDC believes that the route of transmission is mostly via droplets via sneezing, coughing, or talking.

Either way, proper hand hygiene remains very important, as well as the common courtesy of not sneezing/coughing directly on people. Go here: CDC.gov

Also, if you haven’t already gotten your flu vaccine, please go get it. It’s not too late.

Rank Order Lists and the Match

By now, most of the medical students and others participating in the match should have gone on the majority, if not all of their interviews. The Rank Order List deadline for this year’s match is:

FEBRUARY 21
NRMP Match registration and rank order list certification deadline at 9:00 p.m., Eastern Time in the United States.

Certify your rank lists. I’ve talked about this before, but if you haven’t already read my posts, here ya go:

Not in Medicine Mondays, but included for completeness’s sake: Traveling for Interviews

• Residency Interviews
• Mid #Match2017 Evaluation
• Rank Order List for the Match
• Match Day Anxiety
• Congratulations You have matched!
• Post-Match Senioritis
• Post Match Checklist

What should I do now?

Right now I’d recommend you read Rank Order List for the Match and certify a rank order list. You can always certify another rank order list later if you change your mind. However, you want a “default” rank order list to be there just in case for some reason you can’t certify a list. I think the absolute worst case scenario is that you don’t certify any list at all. 

Be warned, just about every year, the day of the deadline, people can’t get in to change their lists. Some people never certified a list in the first place… Don’t let that be you.

Lock in a list now.

This is kind of like answering question on a test. Usually your gut feeling and first decision with a clear head is the most likely to be the “right choice”. Don’t change your answer unless you have an “epiphany” an “ah ha!” moment where you realize your error in judgement.

Additionally, I would also advise against making any changes on the day of the deadline. Last minute decisions are usually a recipe for regret — unless of course, you have the epiphany I described above.

Medicine on the Blockchain?

I love medicine and I’m very interested in crypto, so the marriage of both is of course very interesting to me.

There is a company trying to build an Electronic Medical Record (EMR) on a blockchain. It’s called Medicalchain. The idea itself is very interesting. I’ve always wondered why access to patient information wasn’t easier. I do realize that patient information is very important, but shouldn’t there be a way to get a patient’s medical history quickly as soon as they hit the ER, even if they’ve never been there before?

Of course, the reason for this is because of the segmentation of health records in the United States. The hospital system a mile from you next door to that one probably have very different medical information about you. This idea makes sense to me, however, I think the ability to implement such a system will be very difficult on a large scale. Additionally, medicine traditionally is probably the slowest moving system in terms of adoption of new products.

However, in a more “sandbox” type of healthcare system, I think this could work very well, for example, something like Kaiser or Mayo Clinic. Or it could work in a more isolated area, like Hawaii for example, as long as the all the medical systems in the state were in board.

In general, I don’t know if this kind of thing will work… or if the health care system is ready for it.. yet.

I‘d love to be proven wrong though.

TL;DR

The flu may be airborne this year, get your vaccine and practice good hygiene.

Certify your Rank Order List. Don’t change it unless you have an epiphany.

Electronic Medical Record on a Blockchain? I’m not sure we’re ready for it yet, but maybe in select populations it could work.

-Sensei

Agree? Disagree? Questions, Comments and Suggestions are welcome.

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