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Chief Resident Grand Rounds, presented by Dr. Monica Mullin and Dr. Thomas Swan

Max Moloney, MSc Candidate (Translational Medicine)

During Medical Grand Rounds on February 25th, Queen's Department of Medicine hosted former chief residents Dr. Monica Mullin and Dr. Thomas Swan for two lectures. Dr. Mullin's presentation, entitled "The Skinny on Obesity and Weight Loss", centered around new Canadian guidelines on obesity and a review of current therapies approved for the treatment of obesity in Canada. Dr. Swan then lectured on the topic "Social Media in Medicine", focusing on the unique challenges and opportunities presented by social media in medicine.

 

Dr. Mullin presented obesity as an increasingly prevalent, progressive chronic disease, characterized by abnormal or excessive body fat that impairs health. People living with obesity have an increased chance of morbidity and mortality, in addition to experiencing significant bias and stigma, which add to the burden of obesity [1]. Dr. Mullin explained the importance of evidence-based principles in managing obesity, including validating patients' lived experiences to address the root causes of patients with the condition. Dr. Mullin also reviewed the benefits and risks of bariatric surgery in treating obesity, with an emphasis on the efficacy of the procedure as a weight-loss treatment. Dr. Mullin highlighted that approximately 80% of gastric bypass patients experience a 60-80% loss of excess body weight in the first year [2].

 

Dr. Swan reported that social media, such as Twitter, Facebook, Instagram, and TikTok are powerful online applications that foster user-generated content, social interaction, and real-time collaboration. Many health care professionals utilize these applications to improve education, organizational promotion, professional networking, and public health programs [3]. Dr. Swan detailed how social media can be used as a force for good by improving patients' access to health care information with as much as 74% of people using the internet and social media to search for health information [4]. However, there are also potential risks regarding the distribution of poor-quality information, breaches of patient privacy, and other legal issues that physicians should have a thorough understanding of prior to developing an online presence. To prevent these issues, Dr. Swan suggested healthcare organizations should adopt policies on employee use of social media similar to the policies at Kingston Health Sciences Centre, to mitigate the risks associated with using these platforms.

 

Following their presentations, Dr. Mullin and Dr. Swan participated in a discussion with graduate students of the Translational Medicine (TMED) program. The dialogue began with an explanation of how the Grand Rounds topics could benefit patients. Dr. Mullin emphasized the importance of ensuring new information and guidelines regarding obesity are translated across the entire spectrum of care, from specialist to resident and the patient [5]. Dr. Mullin also commented on the advantages of medical nutritional therapy as a treatment for obesity and how new Canadian guidelines suggest further implementation of this treatment. However, patients experience barriers resulting from the financial cost of the therapy. Dr. Swan expressed his belief in the opportunity to improve the transfer of knowledge and information between physician and patient using social media, which has been cited as an emerging opportunity in translational medicine [6].

 

The discussion then shifted to the media representation of the topics discussed. Dr. Mullin highlighted the stigma of bariatric surgery often displayed in television and film, which generally does not highlight the real-world benefits of the procedure. Dr. Swan explained the risks physicians take in using social media, reiterating the importance of maintaining patient confidentiality, and articulated the benefits of using platforms to keep up to date on high-quality, peer-reviewed research.

 

To conclude, Dr. Mullin and Dr. Swan described their training and career paths that led them to internal medicine residencies at Queen's. Dr. Mullin described her time at Queen's, first as an undergraduate then as a medical student, and finally as a resident as she leaves to pursue a respirology fellowship in Vancouver.  Dr. Swan detailed his journey from entering directly into medical school from high school in the UK to completing his residency in internal medicine in Canada, as well as his choice to complete a fellowship in critical care in the future. Both Dr. Mullin and Dr. Swan emphasized their excitement for their future careers in internal medicine and expressed gratitude to the residency program at Queen's.

 

It was an honour to learn from Dr. Mullin and Dr. Swan in their Grand Rounds lectures and post-rounds discussion. On behalf of the entire TMED program, I would like to thank both Dr. Mullin and Dr. Swan for their time and wish them well as they progress throughout their careers.

 

References

[1] Fruh, S. M., Nadglowski, J., Hall, H. R., Davis, S. L., Crook, E. D., & Zlomke, K. (2016). Obesity Stigma and Bias. Journal for Nurse Practitioners, 12(7), 425–432. https://doi.org/10.1016/j.nurpra.2016.05.013

[2] Elder, K. A., & Wolfe, B. M. (2007). Bariatric Surgery: A Review of Procedures and Outcomes. Gastroenterology, 132(6), 2253–2271. https://doi.org/10.1053/j.gastro.2007.03.057

[3] Househ, M., Borycki, E., & Kushniruk, A. (2014). Empowering patients through social media: The benefits and challenges. Health Informatics Journal, 20(1), 50–58. https://doi.org/10.1177/1460458213476969

[4] Childs, L. M., & Martin, C. Y. (2012, December 1). Social media profiles: Striking the right balance. American Journal of Health-System Pharmacy. American Society of Health-Systems Pharmacy. https://doi.org/10.2146/ajhp120115

[5] Wharton, S., Lau, D. C. W., Vallis, M., Sharma, A. M., Biertho, L., Campbell-Scherer, D., … Wicklum, S. (2020). Obesity in adults: A clinical practice guideline. CMAJ, 192(31), E875–E891. https://doi.org/10.1503/cmaj.191707

[6] Dijkstra, S., Kok, G., Ledford, J. G., Sandalova, E., & Stevelink, R. (2018). Possibilities and Pitfalls of Social Media for Translational Medicine. Frontiers in Medicine, 5(DEC), 345. https://doi.org/10.3389/fmed.2018.00345

Comments

Name
Melinda Chelva

Wed, 03/03/2021 - 11:01

Excellent post Max! Great work highlighting all of the topics that Dr. Mullin and Dr. Swan discussed at the MGR last week.

In my opinion, one of the biggest advantages to social media is its ability to serve as a platform for patients to share their experiences and health journey. Specifically, it can be used to alleviate any stigma associated with sensitive procedures, including weight-reduction surgery.

I was particularly interested to hear that a striking 74% of people use the internet and social media to search for health information (https://doi.org/10.2146/ajhp120115). Knowing this statistic, as Dr. Swan mentioned, it is important to continue to monitor and use online platforms as a way to ensure that patients are continuously being informed with the most latest or up to date research. However, this leads me to the question- who should be responsible for ensuring information on these platforms is relevant and up to date? Should there be one large database (with constantly updated information) that patients are referred to, to search for medical information- will this avoid any inaccurate information from being spread?

With technology evolving, and the world heavily relying on social media, I worry about the future of maintaining “physical” patient-physician relationships. Simi Fromen said it best, “in a world of algorithms, hashtags and followers, [we must] know the true importance of human connection.”

To conclude, it was truly a pleasure to hear the experiences of Dr. Mullin and Dr. Swan, and thank you again Max, for nicely leading the facilitated discussion.

Name
Melinda Chelva

Name
Max Moloney

Wed, 03/03/2021 - 16:44

In reply to by Melinda Chelva (not verified)

Thank you, Melinda! I agree that as patients continue to get more health information from social media we must ensure that what patients are reading is reliable and accurate. The question of who should be responsible for ensuring this information is relevant and up to date raises difficult questions surrounding access to information and filtering of what individuals read through the platforms. In my view, an effective way for the medical community to educate patients is by continuing the trend of open access to information from medical journals. Eliminating paywalls and allowing the public to view studies from the source would certainly help inform the public or at least improve their ability to inform themselves.

Name
Max Moloney

Name
Caitlyn Vlasschaert

Wed, 03/03/2021 - 12:48

What a privilege it was to attend this excellent joint Medical Grand Rounds given by my co-residents and former chiefs Monica and Thomas. Thank you to Max for leading an engaging discussion and summarizing things so well in this blog post.

I particularly appreciated Thomas' shout out to the online nephrology community, which has a pioneered formal social media training program: the Nephrology Social Media Collective internship (NSMC; https://www.nsmc.blog/about). As a recent graduate of this program, I learned how to partake in responsible and effective social media use in medicine from some of the experts. The program leadership has written a few papers on this topic, including: "An introduction and guide to becoming a social media savvy nephrologist" (https://usrl.imgix.net/wp-content/uploads/2020/10/20182203/social-media…) and "Training the Public Physician: The Nephrology Social Media Collective Internship" (https://www.seminarsinnephrology.org/article/S0270-9295(20)30053-X/full…).

There now exist other social media internships such as the CardioNerds Academy (https://www.cardionerds.com/academy/). I am hopeful that there will be formal mentorship opportunities for all kinds of social media interests in the years to come.

Name
Caitlyn Vlasschaert

Thank you, Caitlyn. It is encouraging to see new initiatives such as the Nephrology Social Media Collective working to educate physicians on how to effectively use social media. Training such as the NSMC internship will go a long way to improving physician's understanding of social media and their online presence. It is great to see this trend expanding to other disciplines as well and I believe these programs will be of great benefit to both trainees and the public at-large.

Name
Max Moloney

Name
Jordan Harry

Wed, 03/03/2021 - 15:34

Thank you, Max, for the engaging summary of last weeks MGR. An additional thanks to Dr. Mullin and Dr. Swan for two excellent presentations.
As a person who is not comfortable sharing on social media platforms, I was particularly captivated by Dr. Swan’s presentation. I was very interested in the posting strategies that he shared, and the simple suggestions to ease your way into it. I believe the advice to find some trusted sources that you support, then begin by sharing their content is an excellent way to start. In addition, Dr. Swan suggested that even just making a profile and establishing who you are online is important. I think that he effectively conveyed the importance and duty of medical professionals on these platforms.
I also found the statistic that Dr. Swan shared of 40% of medical news being either fictitious or extrapolated to be shocking. Like my colleague Melinda, I wonder who should be responsible for addressing this and ensuring the content shared is accurate.

Name
Jordan Harry

Name
Kassandra Coyle

Wed, 03/03/2021 - 16:09

Thank you, Max for this eloquent summary of these two wonderful presentations.

In our discussion with Dr. Mullin, we addressed the relationship between obesity and race, and I was surprised to learn that people of Asian descent develop health complications at lower BMI’s than other racial groups (https://doi.org/10.1177/1557988318793259). As Max mentioned, it is incredibly important to ensure that proper guidelines and up-to-date information are translated across the entire spectrum of care. As these guidelines continue to be adapted, I am interested to see if these racial differences will be accounted for.

I personally believe that I have a lot to learn about creating an effective and empowering social media identity and was very grateful to hear Dr. Swan’s presentation. I would also like to thank Caitlyn, for sharing her experiences as an NSMC Intern. As I continue my studies and begin my future career, I would be very interested to partake in a similar initiative to help better my knowledge and experience with social media.

Name
Kassandra Coyle

Name
Charmi Shah

Wed, 03/03/2021 - 17:56

Thank you Max for this wonderful summary, and to Dr. Mullin and Dr. Swan for presenting very relevant and stimulating MGR topics.
 
One of the greatest benefits of social media in my opinion is its ability to engage patients. The relationship between medical professionals and their patients can sometimes be unidirectional, but this is not always ideal. Healthcare professionals (HCPs) want patients to be engaged in their care and be active members in the decision-making process. Social media provides HCPs with the tools to share information, educate, increase awareness, and interact with patients and caregivers. These factors can help empower the patients to engage in their health care and increase shared decision-making.

With the increasing involvement of social media in health care, online posts and claims from medical professionals are often viewed as expert opinions and hold weight. I do believe that HCPs should experience workshops in their schooling that highlight productive social media use, so it was fantastic to hear about this taking place in the Nephrology Social Media Collective internship, as mentioned by Caitlyn. 

Currently, the most pertinent issue with social media appears to be the spread of misinformation. I have seen many HCPs on many social media platforms debunking the “fake news” and spreading evidence-supported information. The CDC constantly sends updates that provide readers with accurate COVID-19 information in an easy-to-read manner; such as https://www.cdc.gov/coronavirus/2019-ncov/faq.html and in pictures: https://wwwnc.cdc.gov/eid/article/27/2/20-3139-f1. I look forward to the creative solutions medical professionals will continue employing to delegitimize misinformation.

Name
Charmi Shah

Thank you, Charmi. I agree that one of the most pertinent issues with social media is facilitating the spread of misinformation. With the influx of poor quality information into social media feeds it will become increasingly important for trusted experts to have a voice on these platforms to ensure patients are well informed as they interact with the health care system.

Name
Max Moloney

Name
Michaela Spence

Fri, 03/05/2021 - 17:45

Thank you Max for the wonderful summary and to Dr. Mullen and Dr. Swan for their engaging presentations.

We covered two very important topics during our discussion after grand rounds last week; obesity and social media. Both of which are not going away any time soon.

I found it very surprising that close to 64% of Canadians over the age of 18 are overweight or obese (https://www.canada.ca/en/public-health/services/publications/healthy-li…) and yet Dr. Mullen mentioned during her presentation that there is a lack of funding supporting treatment. Socioeconomic status plays a large role in the development of obesity as we discussed after rounds. I feel that until we make healthy food more accessible to all members of the community, obesity will only continue to increase in prevalence. I wonder if available funding should be focused more on trying to stop obesity from developing in the first place, if we cannot successfully fund the treatment once it has already become a problem. 

Dr. Swan did a wonderful job inspiring me to seek out help with optimizing my social media presence. Like Kassandra, I also hope to be able to partake in a training program similar to that of the Nephrology Social Media Collective internship that Caitlyn attended. I believe that this training is an asset to anyone either entering or already in the health care field. Acknowledging that social media can be a helpful tool for educating the general public is one step in the right direction for the medical community. Also it will help us to better prepare our own social media posts in a way that facilitates learning and helps mitigate the misinformation circulating the internet.

Name
Michaela Spence

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