Zachary Meisel, an emergency physician at the Hospital of the University of Pennsylvania who is also a Robert Wood Johnson Foundation Clinical Scholar, is Time.com's new "Medical Insider" columnist. A month into his new venture, he has taken on topics including the patient-directed "Google medicine" phenomenon, why abdominal pain is such a difficult, costly and frustrating symptom to treat in the emergency room, and how electronic medical records may -- or may not -- improve patient care. This week, his column convenes other leading minds in academic emergency medicine -- including another Penn emergency doctor, Angela Mills -- to discuss ways to reduce radiation exposure from possibly unnecessary CT scans during ER visits.
I talked with Meisel this week about what he's planning for the Medical Insider, which appears each Wednesday, and how his interest in this type of writing began. He points to his undergrad years at Columbia: As a history major, he wrote a thesis about how the American polio epidemic was framed, shaped, and ultimately transformed by the mass media. Later, in his first venture as a doctor-journalist, writing about quality of care onboard ambulances for Slate back in 2005, he found that writing for a lay audience actually pushed him down new paths for his research. "Much of the stakeholder feedback I got was very rich and helped me formulate the next research questions," he says. Eventually, those insights led to studies that he published in, yes, academic journals. One study that he first presented at the Society for Academic Emergency Medicine conference in 2009, showing that women with chest pain often don't receive proper care en route to the hospital, got plenty of media attention itself, including mentions in Good Housekeeping and Working Mother magazines.
Here's some other snippets from our discussion...
Q: What does this writing opportunity allow you to do that publication in the academic world doesn't?
Clearly, the audience is broader -- but often just as sophisticated. Don't think that Time readers won't call me out for something that they perceive as biased or untrue. But there is a blurring right now -- many of the major academic journals are devoting space and resources to translational efforts. I think they get that evidence for evidence's sake will stall if it isn't disseminated and translated so people can use it. But the biggest challenge is that stories and narratives are often considered anecdotal and biased -- for me, the key is to link a story to evidence so that it tells the truth and also resonates.
Q: What do you hope to impart to patients/medical consumers through these articles?
Three things:
One, that medicine and medical care are complicated. We are challenged every day with hundreds of small, unanswered questions that we have to navigate to provide the best possible care for our patients.
Two, that research will answer many of those questions. But there will always be new ones.
Three, we need to make sure that we spend time and resources on translating science into real policies and actions to promote health.
Q: There are a lot of doctor-writer voices in the crowd these days -- Atul Gawande and Jerry Groopman, to name just two, have both spent many weeks on bestseller lists. What new insights will readers get from your take?
There aren't too many emergency physicians and researchers in this space. Yet people of all stripes and ages have experiences and preconceptions about emergency care. Many of my pieces are framed from an emergency perspective, in part because that is what I know, but also because I think the emergency care world is a microcosm of so many issues that challenge health care delivery today -- cost, efficiency, tradeoffs, quality and safety, communication, local vs. regionalized care, disaster preparedness. And for many people, the emergency room is the interface between the community and the health care world. There are a lot of great stories to tell.