Discussion forums, part 2

Not so long ago I hade some thoughts about a common discussion forum for emergency physicians all around the world. The idea came more from the need than "just because I can do it".

Emergency medicine is a very young specialty in Scandinavia and as such we have a lot to learn and discover. Although my ED can proudly claim to be one of the first and most developed in Scandinavia - we still are no more than 30 or so young and enthusiastic residents but without the backup of emergency medicine specialists who've been there for ages and "seen it all". So we have many questions and ponders over clinical and practical aspects of the ED which require that extra experience and cannot be answered internally. Comparison of treatment methods or approach, types and use of ultrasound devices, prehospital involvement just to name a few examples - a discussion forum would be truly useful for sharing thoughts with colleges abroad and having those special questions answered or at least discussed.

Some might have thought Facebook is all we need and surely it would be sufficient if everyone was familiar and comfortable with it's privacy hassle. It turns out doctors are paranoid as cats in the bathtub and I've never been able to engage projects with FB because of this, frustrating as it is. Twitter is another option and with the use of a selected hash-tag, say #em-forum, it should be easy to setup a centralized, simple to use platform. But tweets are limited to 140 characters only and discussions are open to the whole Internet. And then too many doctors don't even have a Twitter account, except for Dr. Bailey who just jumped onboard.

I exchanged my thoughts with the ever hyperproductive LITFL guys and they reminded me of http://www.doctors.net.uk which is essentially a social network (Facebook like) platform where registration is moderated so that there are only doctors signed in. I must admit, I haven't been there for a while but the mere idea of persuading thousands of emergency physicians to register and try it out gives me chills all the way from brainstem down to cauda equina. I actually tried once using the free-and-easy-to-use Ning social-networking platform to engage my colleges - they liked the idea but signup/login treshold and a miniscule learning curve was still enough to kill it in birth. Doctors are busy, conservative (just a polite way of saying IT-lazy) and generally exhausted - everything new needs to be dead simple, easy, ready-to-use and again; dead simple.

That leaves us with only one option, email. Every doctor has an email and reads it on a daily basis or so. A server backup-ed, email based postlist system with functions to moderate content and members would be absolutely necessary. Members would want to have an option to login to change their profile and settings (receive immediately or digested content) and even go back in time and read older posts in the archive. Members should be able to see each others and even contact them individually. The system should still be closed for the public, that is - open for special registration/invitation only.
Is this starting to sound like Google Groups? Well, it is. GG is the only system I have managed to use to successfully get together a group of doctors and believe me, I've tried a lot of platforms.


Besides being a tip for you if you wan't to engage your colleges at work for off-work discussions, this will be my attempt to make a unified discussion platform for enthusiastic and alike emergency physicians all around the world. Now that I have colleges in USA, Australia, Iceland, Sweden and UK - this surely has a potential for multicultural emergency medicine discussions. So if you feel interested please feel free to invite yourself at
 https://groups.google.com/group/em-physicians

We'll see what this expirement leads to!

Subscribe to clinical pearls

There are all kinds of pearls floating around on the ocean floor of the Internet but we want those that are so tiny small that we can read them at a glance but still feel like full like after a Christmas evening meal. So small actually that we can have them as email. Luckily for us there are colleges out there who think the same and have made these pearls.

Here are my all time favorites, the ones I've hanged on to:

• Educational Pearls from University of Maryland School of Medicine
  Since 2007 the Maryland EPs (and again Amal Mattu is on-board, amazing how all the best EM stuff on the Net in the end winds up to Mr. Mattu!) have made one daily clinical pearl for a broad selection of EM topics. Short as skirts, information-packed as a sunny italian beach - it's a joy to be a subscriber to. And if you as me start the subscription but feel like you've missed out - you can even browse through their archives. Amazing work and will most likely go to the history books!
• EMedHome
  This is a respectable website with great emergency physicians onboard such as Peter Rosen and Amal Mattu just to mention a few. Not surprisingly then their content is of highest quality. EMedHome is actually a multi-functional website with podcasts and full text articles on updates on hot emergency medicine topics and you can read more about them in my resources list.
  As a member you can have emailed to you daily clinical question (with answer) and weekly clinical pearl, the last one I got was about 3 critical ECG features to differentiate anterior ischemia from posterior MI, a real case we had just days ago!

When I started this blogpost I thought I would be mentioning at least 5-6 of various sources. After digging trough my previous and current subscriptions I found some of my subscriptions are more like packed newsletters (like Journal Watch's high quality journal updates or Medscape's various and detailed daily/weekly email subscriptions) than tiny clinical pearls.

So email pearls aren't so many after all but my preference is quality, not quantity. My inbox is as fragile as my cornea and everything that goes into it is there for a good reason. Email overload drains your energy faster than the Krebs cycle. That's why RSS is an extraordinary solution and I am amazed so often I find out my colleges don't what what it is. Try to see RSS as "passive email", something that doesn't require your immediate attention but waits for you until you are ready. Like a newspaper actually - after all your RSS list is a compilation of headlines from all your favorite sources like blogs, newsletters or even academic journals. RSS is as essential to surviving the 21th century information overload as a pocket knife is in the jungle of Amazon. Lifeinthefastlane has an excellent article, "RSS for dummies" worth checking out.

Here are my favorite RSS clinical pearls:

• Michelle Lin has a wonderful "tricks of the trade" series on her blog with pearls that you can immediately take home to your clinical work.
• If you accept Q/A form as a clinical pearl, a few Detroit EPs have made this fantastic blog with a weekly clinical question which then i answered a few days later. They even accept answers with email and have a score board for you to tickle you ambitions. The questions are very applicable.

This will be all folks. They aren't many but they sure are good. Please let me know if you have any more to add to this list!