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Justin Moore, MD, has thoughts.

Links for Thursday, August 3, 2017: Robot Soccer, Weight Watchers can't pivot its message, Overuse of back surgery in professional athletes, and non-lecture based medical school

August 3, 2017

First things first: for any of you subscribing to the RSS feed of this blog, I've reduced the frequency of emails. Look for them on Thursdays at 10 am now. Moving on...

Humanoid robots are hilariously terrible at soccer (for now)

Weight Watchers is having a hard time adjusting its message to a more wellness-oriented and less weight-oriented world

The fact that we talk more about "wellness" and less about weight now isn't completely by accident:

In late 2015, Women’s Health, a holdout, announced in its own pages that it was doing away with the cover phrases ‘‘drop two sizes’’ and ‘‘bikini body.’’ The word ‘‘wellness’’ came to prominence. People were now fasting and eating clean and cleansing and making lifestyle changes, which, by all available evidence, is exactly like dieting.

I was the Medical Director of a large weight-loss clinic for several years earlier in my career. The quotes from people at Obesity Week in this article are heartbreaking:

I am 41, I would say. I am 41 and accomplished and a beloved wife and a good mother and a hard worker and a contributor to society and I am learning how to eat a goddamned raisin. How did this all go so wrong for me?

I'd much rather talk to people about being "well" and "happy" and "strong." Any day.

Are professional athletes the canary in the coal mine of excessive back surgery?

Should the experience of Tiger Woods and Steve Kerr help others make decisions about surgery? We imagine that they both received care from the most highly esteemed professionals, that cost was not an obstacle, and that their care was attentive. Presumably, their results did not meet expectations discussed with their providers. Steve Kerr has sought to share his experience with others and advised during an April 23 press conference, “I can tell you if you’re listening out there, if you have a back problem, stay away from surgery. I can say that from the bottom of my heart. Rehab, rehab, rehab. Don’t let anybody get in there.” Recent media reports indicate that Tiger Woods not only continues to experience back pain that is impeding his play, but additional consequences include side effects associated with opiate pain relievers.

Medical schools are moving away from the "Sage on the Stage" method of teaching

My medical school experience was very analog. We “learned” almost everything we learned via notes on those lectures. Most of the lectures were bad. Think “Bueller?” but with thyroid tumors. So, like this article notes, a small minority of students actually attended them. Maybe forty people (out of 175 in the class) sat and took in all they could in an hour of truly uninspired public speaking. So most of us acted on the judgement that our time was simply better spent elsewhere studying. We hired one another via a "note service" to take notes at lectures and distribute them by hand. Piles of photocopied notes filled the atrium outside the lecture hall daily. It was depressing.

I'm still volunteer faculty at the University of Kansas School of Medicine-Wichita. I teach a "problem-based learning" session about every other week. KUSM-W is in the process of moving to a curriculum that is almost completely problem-based. I enjoy the sessions as an instructor, but I wonder if they would have caused me some anxiety as a student; they're much more free-flowing than a set of notes to plow through. But the literature seems to indicate that they increase retention and more importantly, increase the likelihood of team-based practice in the future. 

In link dump Tags back surgery, robots, weight loss, physical activity, medical education
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