Clifford A. Hudis, MD, FACP
Just a few years ago, Clifford A. Hudis, MD, FACP, chief of the breast cancer medicine service at Memorial Sloan Kettering Cancer Center and a professor of medicine at Weill Cornell Medical College, both in New York City, gave a presentation at the 2009 American Society of Clinical Oncology (ASCO) meeting about how oncologists could stay up to date on the explosion of medical information and knowledge available. At the time, Hudis was a member of ASCO’s board of directors; he subsequently became ASCO president in 2013-14. In the webinar, he advocated establishing RSS feeds so that users could receive stories, abstracts, and research directly to one’s email inbox, and he urged attendees to “figure out an efficient way to get what you want. It’s easy to set up in a world where we are inundated with information.”
In 2014, the amount of medical and other information has only increased, and mobile devices such as smartphones and tablets make it even easier to access that data. “Today is not any different than before, but there are more channels of information, more sources,” said Hudis, now immediate past president of ASCO, in a recent phone interview. “Because of electronic publication, the medical information comes at us faster. The doctor has to be even more skilled to determine what is important and what is important in the context of clinical care.”
Understanding that context is crucial for helping cancer patients receive the best medical care available, while following what have become standards of that cancer care. Staying current involves paying attention to evolving guidelines, written using transparent rules, and knowing what the erudite cancer organizations are saying, said Hudis. Such standards “allow for an informed starting point. They are treatment guidelines but allow doctors to use their skills to know where to deviate” from the standards when necessary.Mobile Devices Emerge
Everyone has the same 24 hours in a day to get things done. Once the day has been portioned off into time for sleep, personal care, family time and work, which can include patient care, administrative tasks, research, and more, how does staying current fit into the mix?
Digital mobility makes it easier.
“We do not just rely on our desktop computers anymore,” said Rogerio Lilenbaum, the chief medical officer for Smilow Cancer Hospital at Yale New Haven and a practicing thoracic oncologist. “It’s incredibly easy to access this information from anywhere on a mobile. It’s more—I don’t want to say it’s passive, because it does take active management to filter what is important to you. But it’s not how it used to be. When was the last time a physician walked into a library, for God’s sake? It just doesn’t happen anymore.”
Historically, physicians depended on textbooks and journal articles to learn about emerging data, and attended annual meetings from ASCO, and other professional associations such as the American Society of Hematology and the American Society for Radiation Oncology, said Lilenbaum, who has been practicing medicine for about two decades. Continuing medical education courses and other events helped disseminate new information about the field. But since around 1998 or 2000, Lilenbaum said, the Internet has transformed everything. “People still care about journal articles, but access them online instead of in print,” he said. “People still go to ASCO, but the meetings have a different value. They’re more about networking and getting to know other people and institutions, rather than about obtaining information. And textbooks, I think, have lost a lot of their applicability except as a source for a subject review.”
Instead, Lilenbaum and others rely on daily email roundups from organizations like ASCO, journal abstracts sent electronically, and access other updates from online resources such as Medscape. Searching PubMed, a database of more than 24 million biomedical citations from medical journals, books, and other resources, for clinical updates on specialized topics is another way to stay informed, said Amer Zeidan, MBBS, MHS, an assistant professor of medicine in the section of hematology in the department of internal medicine at Yale University in New Haven, Connecticut, who specializes in myelodysplastic syndromes. “I go to PubMed regularly and look up any recent papers in my area to make sure I stay updated,” he said. “Trying to keep up with recent review articles is a wonderful way to summarize the new knowledge in the last couple of years.”