April 11, 2020, “They Developed Their Coronavirus Vaccine in Salk’s Shadow,” Salena Zito, The Wall Street Journal, p. A11:

Jonas Salk developed the polio vaccine at a University of Pittsburgh lab. Louis Falo and Andrea Gambotto, respectively a dermatologist and a surgeon, have developed a Covid-19 inoculation that rapidly produces large numbers of coronavirus antibodies when injected in mice. A peer reviewed paper described their work in the journal EBioMedicine, published by The Lancet. They await approval from the Food and Drug Administration to conduct human trials on their”possible inoculation that you’d apply like a Band-Aid” via a unique skin patch containing 400 tiny needles. It does not require refrigeration and could be put in boxes, stored, shipped, and distributed globally. According to Dr. Falo, this is “really important for undeveloped countries who don’t have the means of keeping vaccines cold the entire time.

Ethical questions – “Contact Tracing Tools – Privacy concerns

April 14, 2020, “Google, Apple Join To Track Patients”, Tripp Mickle, Rob Copeland, and Sam Schechner, The Wall Street Journal, p. 1 and A10:

Apple Inc and Google, two Silicon Valley giants and rivals jointly announced they are developing “contact tracing tools” to be built into smartphones, “using existing Blue tooth technology that tracks whether phones have passed within a certain distance of one another.”

Some praised Apple and Google’s system because it is decentralized as compared to a central server where all data is uploaded and could be misused. Michael Veale, an assistant professor of digital rights and regulations at University College London stated “This is a very effective power play in favor of privacy by Apple and Google. They have made a very conscious decision against very centralized databases, while still giving epidemiologists the data they need.”

Pandemic response training – preplanning

April 14, 2020, “Med School Needs an Overhaul”, Stanley Goldfarb, The Wall Street Journal, p. A15:

Dr. Goldfarb, is a former associate dean of curriculum at the University of Pennsylvania’s Perelman School of Medicine

This article suggests medical school curricular reform to take into account the essential role physicians play in a public-health crisis.

Medical school students should enter the field of medicine with the tools and training to succeed in fighting deadly pandemic diseases like Covid-19 and the next pandemic.

The author recommends that pandemic response or practical preparation for widespread and sustained emergency should be part of American medical school training and include a strong grounding in public health issues or disaster preparedness.

Many medical schools do not require students to do formal training in emergency medicine. During residencies physicians receive valuable practical experience in internal medicine and surgery however in addition they should also have the benefit of rigorous classroom study in ventilator management and other aspects of critical-care medicine, preferably in the fourth year of medical school.

In the wake of the Covid-19 crisis, a critical examination of undergraduate medical education will be among the many reassessments the United States has to make. Epidemic models, statistics, along with the principles of drug testing, nature of the scientific method, and the meaning (both positive and negative) of uncontrolled drug trials, are some additional topics to be considered for medical school training of doctors. The design of randomized controlled trials or other complex experimental approaches is a complicated topic.

The article states that “Above all, the medical profession should abandon the fantasy that physicians can be trained to solve the problems of poverty, food, insecurity and racism. They have no clinical tools with which to address these issues. The public may not realize that the well-funded organizations like the Beyond Flexner Alliance advocate for devoting a substantial part of medical-school teaching to social and organizational topics”.

Digital Health

Ethical questions – how new technology impacts physicians

July 2019, “Are You Ok?,” subtitle “Amazon Files New Patent to Detect Emotions,” Peggy Keene, Texas Bar Journal, p. 492:

By monitoring patent filings one can see that Amazon filed a patent, “Voice-based determination of physical and emotional characteristics of users“. What kind of data is Amazon collecting and how is that data going to be used? Will the data be shared or sold to insurers and then will insurers use the data to potentially deny coverage based on “pre-existing conditions”?

Amazon stated that the patent would allow Alex to recognize abnormalities in the user’s voice. This would subsequently allow Alexa to recognize if the user was sick. Per the article, “For example, through comparison to previously recorded data of a user’s voice, Alexa would recognize whether the user might be sick due to health-related issues, sleepiness, and other health conditions. This would allow Alexa to suggest products such as cough medicine or cold syrup to the user.”

Leadership

May 14, 2019: “To Be a Better Leader, Ask Better Questions,” subtitle “Most bosses think they have all the answers. But the best bosses know what to ask to encourage fresh thinking. Here’s how to do that.,” Hal Gregersen, The Wall Street Journal, p. R2:

According to the author of this article, Dr. Gregorsen, executive director of the MIT Leadership Center, a senior lecturer at the MIT Sloan School of Management and author of “Questions are the Answer”:

Bosses should reconceive what their primary job is. Their job is to build their organization’s capacity for constant innovation.

Highlights:

  1. Understand what kinds of questions spark creative thinking.
  2. Create the habit of asking questions.
  3. Fuel that habit by making yourself generate new questions.
  4. Respond with the power of the pause.
  5. Brainstorm for questions.
  6. Reward your questioners.

(1) Understand what kinds of questions spark creative thinking. To knock down barriers to creative thinking and channel energy into more productive pathways, a question has the following 5 traits: (1) It reframes the problem. (2) It intrigues the imagination. (3) It invites others’ thinking. (4) It opens up space for different answers. (5) And it’s nonaggressive – not posed to embarrass, humiliate or assert power over the other party.

For example, a CEO could ask open ended questions such as: What are you wrestling with and how can I help? If you were in my shoes, what would you be doing differently than what you see us doing today?

If one want to turn this first point into a trackable activity, one could start noting in a daily journal how may questions you have asked that meet the five criteria.

(2) Create the habit of asking questions. Peter Drucker liked to jump-start strategic thinking by asking: “What changes have recently happened that don’t fit ‘what everyone knows'”?

(3) Fuel that habit by making yourself generate new questions. Everyday note something in your environment that is intriguing and possibly a signal of change in the air. Exercise your questioning muscles.

(4) Respond with the power of the pause. Don’t immediately respond with an answer. Make it your habit to respond with a question – ideally one that reframes the problem, not the “well, what do YOU think we should do?”. At least respond with a question that draws out more of your colleague’s thoughts on the matter.

Some examples of questions to help think through how decisions should be made include: “What are we optimizing for? What’s the most important thing we have to achieve with whatever direction we take? What makes this decision so hard? What problem felt like this in the past?”

(5) Brainstorm for questions. Whenever you or your team is at an impasse, or there is a sense some insight is eluding you regarding a problem or opportunity, just stop and spend four minutes generating nothing but questions about it. Go for high volume and do no editing in progress. See if you can generate at least 15-20 questions.

This will often yield a new way to look at the challenge and at least one new idea to solve it. For example, a company struggling to come up with a new concept to test, tried the question bursts approach. It started with “What if we launched a response to [a competitor’s product] and did it better? Are we stuck on assuming a certain price range? What if a customer was willing to give us 10 times that – what could we deliver that would be that valuable to them?” The team zeroed in on that question and started generating more exciting ideas.

(6) Reward your questioners. Keep track of how you respond when someone asks a question that challenges how you have been approaching a problem or feels like it threatens to derail a solution train already leaving the station. At one company, the boss always surprised his top team by being willing to hear out even the craziest ides. He would say “Wait, say more…” to find that part that could work.