Slow Medicine and Choosing Wisely: a synergistic alliance

Choosing Wisely® is an initiative of the American Board of Internal Medicine Foundation to help physicians and patients engage in conversations about the overuse of tests and procedures and support physician efforts to help patients make smart and effective care choices. Choosing Wisely campaigns are now active and present in 25 countries around the world, on five continents. Italy is the only country where a Choosing Wisely campaign was launched, and it is currently steered by a Nationwide association (Slow Medicine), creating a synergistic alliance. The Slow Medicine Association was founded in 2011 when a group of health professionals and citizens shared a new paradigm of values, methodology, and interventions and decided to establish an association with the mission of working for a health system driven by ethics and quality principles. Three keywords summarize the philosophy of Slow Medicine: measured because it acts with moderation, gradualness, and without waste; respectful because it is attentive to the dignity of individuals recognizing their values; and equitable because it is committed to ensuring appropriate care based on the best available evidence. Slow Medicine allowed the spread of Choosing Wisely in Italy involving several professional societies and participating at the National meetings of the Societies as well as numerous other meetings, in which the mission of the Association is combined with the principle of the ‘do not’ recommendations. Numerous other initiatives were carried out, and new projects were planned in synergy with Choosing Wisely.

Reports of the Death of Expertise May Be Exaggerated: Limits on Knowledge Resistance in Health and Medicine

During the past decade the idea that expertise is dead, or at best moribund, has become commonplace. Knowledge resistance appears to be growing more politicized and is increasing across a wide range of science-based topics, such as agriculture, evolution and genetics, vaccination, and climate change; even flat-earth beliefs are undergoing a renaissance. But in many of these areas, denying expert authority is cost-free in everyday behavior, making it more rational for people to prize identity and group affiliation over realism. To probe the health of expertise in a domain with everyday consequences for knowledge resistance, we conducted three incentive-compatible studies of laypeople’s preferences for sources of information they would read about specific medical conditions (e.g., heart disease, cancer, COVID-19). We found quite rational preference patterns, by which people preferred sources based on experts (physicians and scientists) over non-experts (celebrities and politicians) and group consensus (professional societies, polls) over individual opinions. These findings held most strongly for issues of personal medical concern, but were robust for less concerning health conditions, and for the highly politicized topic of COVID-19. Individuals who scored higher in intellectual humility and preferences for rational over experiential thinking were more likely to prefer the most expert sources. Expertise retains broad respect in the medical domain, at least when one’s own health is at stake.

Pump Technology Interchange As Embraced by Dr. S. Gopalakrishan, Vice President, Technology Flowserve Pump Division

Himself a major technical team player in a for-profit corporation, the stance adopted by Dr. S. Gopalakrishnan vis à vis the wider engineering community is examined and found to be instructive for technology leadership in general. First, in the context of his particular experience, are highlighted the mutual benefits of a corporation maintaining relationships with universities. Then come the similar advantages of his participation in professional societies and symposia and the attendant contributions to the open literature, including the competitive drive for doing so. Such activity fortuitously led him to the more direct relationships with competitors that characterize a research consortium of manufacturers in the same industry.

Clinical Practice in Spine Surgery: An International Survey

Background The availability of diverse and sophisticated surgical options to treat spine conditions is compounded by the scarcity of high-level evidence to guide decision-making. Although studies on discrete treatments are frequently published, little information is available regarding real-world surgical practice. We intended to survey spine surgeons to assess clinical management of common spine diagnosis in day-to-day settings. Methods An online survey was distributed among neurosurgeons and orthopaedic surgeons worldwide. The obtained assessment of common surgical practice is contextualized in a review of the best available evidence. Results The survey was answered by more than 310 members of several European, Australasian, and South African professional societies. The submitted responses translate a surgical practice generally grounded on evidence, favoring well-tried techniques, providing comprehensive treatment for the most severe diagnoses. Such practice comes mostly from neurosurgeons focused on spine surgery, practicing in teaching hospitals. Conclusion We believe that the pragmatic, day-to-day approach to spine conditions captured in the present survey offers an informative insight to involved surgeons.

Psychodynamic Psychiatry in the Philippines

The authors describe the practice of psychodynamic psychiatry in the Philippines. They review features of contemporary psychodynamic psychiatry, the state of psychodynamic psychiatry in training programs, and its integration in national professional societies. Despite psychodynamic psychiatry's wide acceptance in the professional community in the Philippines and neighboring Southeast Asian countries, delivery of care to over 110 million residents of the archipelago requires creativity given the small number of psychiatrists. The authors discuss how psychodynamic psychiatry impacts the national mental health scene and propose future directions involving forging international linkages.

Chronicling the Journey of the Society for the Advancement in Biology Education Research (SABER) in its Effort to Become Antiracist: From Acknowledgement to Action

The tragic murder of Mr. George Floyd brought to the head long-standing issues of racial justice and equity in the United States and beyond. This prompted many institutions of higher education, including professional organizations and societies, to engage in long-overdue conversations about the role of scientific institutions in perpetuating racism. Similar to many professional societies and organizations, the Society for the Advancement of Biology Education Research (SABER), a leading international professional organization for discipline-based biology education researchers, has long struggled with a lack of representation of People of Color (POC) at all levels within the organization. The events surrounding Mr. Floyd’s death prompted the members of SABER to engage in conversations to promote self-reflection and discussion on how the society could become more antiracist and inclusive. These, in turn, resulted in several initiatives that led to concrete actions to support POC, increase their representation, and amplify their voices within SABER. These initiatives included: a self-study of SABER to determine challenges and identify ways to address them, a year-long seminar series focused on issues of social justice and inclusion, a special interest group to provide networking opportunities for POC and to center their voices, and an increase in the diversity of keynote speakers and seminar topics at SABER conferences. In this article, we chronicle the journey of SABER in its efforts to become more inclusive and antiracist. We are interested in increasing POC representation within our community and seek to bring our resources and scholarship to reimagine professional societies as catalyst agents towards an equitable antiracist experience. Specifically, we describe the 12 concrete actions that SABER enacted over a period of a year and the results from these actions so far. In addition, we discuss remaining challenges and future steps to continue to build a more welcoming, inclusive, and equitable space for all biology education researchers, especially our POC members. Ultimately, we hope that the steps undertaken by SABER will enable many more professional societies to embark on their reflection journeys to further broaden scientific communities.

Telegenetics and COVID 19: Through the Pandemic and Beyond

Introduction - The COVID 19 pandemic led to restrictions on the conventional ways of healthcare delivery. Telemedicine provided a viable solution that was in line with the social distancing policies imposed to minimize disease transmission. This demanded physicians adapt to new ways of healthcare delivery. We surveyed geneticists across the country to determine their experience and to ascertain if telegenetics will be a lasting change. Materials and Methods - A 23 item standardized survey was distributed to various US-based geneticists via email and other social media platforms focusing on their experience of providing care via telemedicine. Results - We received 69 responses from physicians across 26 states. Of these, 91% practiced in academia. 70% responded that pediatric genetics takes up more than 50% of their practice. 68% had over 50% of their practice switch to telemedicine. 77% felt they could provide adequate care via telemedicine and 94% of providers would like to continue telemedicine post-pandemic. Conclusion - The future of telemedicine looks promising as the majority of clinicians would like to routinely use telemedicine post-pandemic. Uniform guidelines for use of telemedicine in genetics may need to be proposed by professional societies and supported by federal laws.