Saturday 2 January 2016

Reading About Healthcare

I like to read. A lot. About all different things, but being in medical school, I like to keep up with what's going on in healthcare. Knowing that I get a lot of traffic from pre-meds and other medical students, I thought I'd share the resources I use to stay up-to-date on what's going on in healthcare outside of my local bubble.

Blogs
The Incidental Economist (link)
Focusing on healthcare policy, particularly from an economic perspective, TIE does a great job of contextualizing system-level concepts in medicine. Their posts are well-written and provide non-technical explanations for technical subjects. There is a fair bit of medicine in there too - most of the contributors are policy experts rather than physicians, but Aaron Carroll is a pediatrician who does a great job of using an evidenced-based approach to common medical or quasi-medical questions. He also makes very helpful short videos! It's a bit American-centric, so not every topic applies well to the Canadian healthcare system, but being concept-focused, even the American topics provide some useful means of understanding healthcare in Canada too. Overall, I find this site to be my highest-yield resource. Check it out if you've got a real interest in healthcare policy.

Healthy Debate (link)
Canadian content, which is great, and there are some articles with some really unique insights into the Canadian system. It doesn't have too many contributors however, and I find some of the articles to be a bit fluffy, so I don't check the site often. In typical Canadian fashion, it also tends to play things fairly safe, with many articles taking rather non-controversial or vague stands on issues. In some ways, it's more a news site than a blog or opinion site. Where Healthy Debate does shine is in the comments, which are generally high-quality and provide for reasonably insightful discussions. Posters are more willing to take hard stands - and to defend their viewpoints - which also gives a good look into prevailing opinions in Canada's healthcare system, including those of physicians. It's worth checking out every month or so.

KevinMD (link)
In many ways the grand-daddy of healthcare blogs, KevinMD is now mostly an aggregator of blog posts from other blogs, some better than others. It's an American site with a distinctly American focus, so a lot of what's on there has minimal value for Canadians. There's also a fair number of fluff pieces. Still, it updates so regularly that even if only one in four posts catch your interest, there's still plenty of content to go through. The comment section provides some interesting viewpoints from our American colleagues, but don't get too absorbed in them - unlike Healthy Debate, this is not a place for measured discussion. Opinions get thrown around with little or poor justification and seem permanently unresponsive to counter-points. It's also a rather commercial enterprise, with Kevin Pho, the site's founder, talking a lot about how physicians can increase their online presence. It's a great resource for bloggers if your primary goal is to be seen/heard by more people, but being a content-focused person, I find the emphasis on wide exposure rather than quality content a bit off-putting at times.

Evidence Network (link)
A University of Manitoba-based collaboration project between healthcare policy experts from a variety of backgrounds, the Evidence Network provides easy-to-understand position pieces and commentary on the Canadian healthcare system. It's not exactly a blog, so it doesn't seem to update too often, but the quality of the pieces is exceptional - as the name suggests, they really draw off the evidence in a comprehensive manner. Most of their positions are nothing I haven't heard before, but their circle of experts have expressed them in such a clear, concise, Canada-specific manner that they're worth a thorough read. Anyone looking for an introduction or refresher on Canadian healthcare policy, particularly from an economics perspective, could do a lot worse than reading the Evidence Network's articles.

Doctor Grumpy in the House (link)
Uses examples from Doctor Grumpy's practice to highlight the absurdities present in medicine. American practice, but the instances are generally quite applicable to Canada. Always hilarious, usually not too serious. Good for a laugh every now and then for stress relief.

Forums
Premed101 (link)
Needs no introduction - if you're on my blog, you probably got here from Premed101. Good resource for Canadians looking to navigate getting into medical school or residency, arguably the only free, reliable, online resource for some important questions. Canadian-focused, so a bit of a smaller community which goes through periods of relative inactivity. Also a bit dominated by a small group of posters - which I'll fully admit includes me - so what gets posted isn't exactly representative of the broader community in undergrad, medical school, or residency, but I do find there's at least a range of opinion and room for different ideas. I've had some excellent discussions on Premed101, which is why I generally keep coming back to it.

Student Doctor Network (link)
The American Premed101 (ok, it's probably the other way around), it's a great resource if you're looking at doing anything in the US. Bigger community, so it's a decent place to get a variety of perspectives on medicine. Chock-full of useful or funny anecdotes if you search around enough. Not the greatest forum for discussion - threads seem to get pretty non-constructive fairly quickly - but still good for simple data-gathering about viewpoints about medicine, particularly from an American perspective.

News Sites
Medicine is a social occupation. Healthcare is very much society-dependent, and society is changing all the time. I find it very useful to keep up with the world outside of medicine, or at least to see what non-medical people read about healthcare. I meander between different news organizations when trying to get general information about the state of the world, including the CBC, the Globe and Mail, Maclean's, the Guardian, CNN, the New York Times, the Washington Post... it's changed a lot. My go-to at the moment is...

Vox (link)
Started by a bunch of younger, established, left-leaning journalists a few years ago, Vox is an online-only news organization. It tends to go a bit beyond reporting the immediate story of current events, instead trying to inject some fact-checking, context, or counter-points to common media narratives. This raises the level of reporting substantially and avoids some common journalistic pitfalls. The problem with trying to inject context into news, however, is a higher potential for bias. It's a left-leaning site (for an American organization at least) and sometimes misses or ignores contextualizing information that goes against established viewpoints of their main staff. These tend not to be egregious errors and because their articles actually make concrete conclusions, they're pretty transparent about their viewpoints, so at least it's easy to clue into where their bias lies. It's not a uniquely good news site, but I'd say it's a cut above most.

Raw Data Sources
Canada has a large number of organizations that collect information on the state of healthcare, so no one site is going to have all the necessary information. Government departments (local, provincial, and federal), physician organizations (CMA, OMA), and accrediting bodies (CFPC, RCPSC) all have good data. Here are the sites I visit most often for raw data.

CaRMS (link)
Everyone involved in Canadian medical education knows about CaRMS. It's the organization that handles our residency matching process, the most important post-medical school admissions event, so it's kind of a big deal. It's also a fantastic source of data on the Canadian medical education system. They've got reports on residency matches stretching back decades, as well as program information for the current match cycle. I pull a lot of raw data from them when looking at the medical education pipeline.

CIHI (link
The Canadian Institute for Health Information is not a site I visit often, but if you're looking for an obscure data point on healthcare in Canada, if you find it anywhere, chances are you'll find it there.

Health Force Ontario (link)
The most comprehensive job posting sites for physicians. Far from complete - a good number of positions for doctors aren't posted anywhere - but it's a large and searchable database, which puts it a good cut above anything else I've found. I like it for the purposes of contextualizing future career opportunities. Finding even one job that is appealing in a specialty is a great motivator to go into it, to see what's at the end of the tunnel. Many other provinces have similar sites (British Columbia's is notably excellent).

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