“If our conferences become more problem-focused as opposed to more traditional discipline-focused, you’ll see these diverse groups coming together. Which I think is exciting and sort of mind-opening.” – Clay Johnston, dean of the Dell Medical School at the University of Texas at Austin.
Clay Johnston thinks the U.S. healthcare system is broken. Health costs in the U.S. are much higher than any other country, yet our outcomes are ranked 34th in the world, he told Convene podcast host Ashley Milne-Tyte. Johnston has some ideas for how to address that, beginning with the way in which phycisians are trained and receive continuing medical attention.
We looked at the future of medical meetings in our cover story this month, and in this conversation, Johnston and Milne-Tyte delve deep into how medical conferences traditionally have been structured, what’s already changing, and why the industry still has a long way to go.
Read the full transcript below:
Ashley Milne-Tyte: Welcome to the Convene Podcast. I’m your host, Ashley Milne-Tyte. This time on the podcast we meet Clay Johnston, dean of the Dell Medical School at the University of Texas at Austin. He says medical conferences are ripe for an overhaul, but change is happening slowly.
Clay Johnston: All you have to do is have some well-known speaker stand up there and you’ve just entertained a thousand people in the audience, right? And these interactive approaches are much more labor intensive.
AM-T: Clay Johnston has been dean of UT Austin’s medical school for three years. Naturally, he’s invested in medical education – specifically in making that education more hands-on, less lecture-based. But before we started talking about conferences, I asked him to talk about the healthcare system in general. It’s almost become a cliché, the assertion that the US healthcare system is broken. Clay says there’s plenty of evidence to support that.
CJ: I mean one example for the U.S. is our healthcare prices are substantially higher than any other country. So 30% higher than Switzerland yet our health outcomes are by the WHO ranked 34th – between Costa Rica and Cuba. We spend about 9,000 a year on healthcare, in Cuba they spend 800, and yet they live as long as we do.
AM-T: Another example, he says: doctors and patients generally can’t email each other, even though email might be an efficient way to get questions answered.
CJ: Another is that half of patients aren’t taking their medications as directed three months after the prescription is written, and we do nothing to monitor that, provide tools, track knowledge, help people with that problem.
AM-T: He says that is the number one reason drugs don’t work —people just aren’t taking them correctly. He believes conferences can play a role in better healthcare outcomes because they’re an important part of medical education. But for now, he says they have a ways to go. First, he started talking about how his school is training the physicians of the future. It’s quite a contrast to the way he was trained.
CJ: So there’s differences in content now than when I went to medical school. The facts-based memorization approach to teaching is much less relevant, it’s much more about problem solving and more about the systems of care and all that, and then the way in which we teach also needs to change. They can’t listen to lectures for 45 minutes and take notes and take tests, that just doesn’t work well.
AM-T: He says their curriculum is based instead on team-based problem solving. So medical students need to learn certain materials, there are some lectures, but they can be recorded and listened to at home. The classroom is used for thrashing through problems as a group, and working out solutions. He says even the classroom is set up so that people can break into small groups at tables to discuss their cases.
CJ: That also reinforces the way we need to approach healthcare, which is as a team sport, not an individual sport…and reminding people of the importance of the different perspectives that come into the room. So in terms of conferences, yes, they’ve shortened their presentations — there’s the longer presentations one gets as the plenaries, and the shorter, scientific presentations. But they’re still really about somebody broadcasting from the front of the auditorium and everyone else sitting placidly in their seats and maybe asking questions at the end.
AM-T: He says creating more interaction and creating an environment where attendees can work together on cases – that would be a much more effecting learning tool at health conferences.
AM-T: You know you were talking about, that’s not how adults learn, sitting in a lecture hall or classroom and listening to someone at the front, taking notes. I mean unfortunately it’s certainly that’s how I was forced to learn throughout my education, and I’m interested in whether you think this is a generational difference. In that we may not have liked that way of learning, but that was just the way we were taught. And now people in their early 20s, they haven’t grown up in the same learning environment. They’re used to interaction in a way you weren’t if you grew up going to school in the 60s, 70s, 80s…
CJ: I think that’s right. I mean the other difference is that for us conveying facts was a key function of education. ‘You should know the entire periodic table,’ whereas today that would be seen as silly. The periodic table is available at the touch of a finger.
AM-T: On your phone or computer. He says today’s classroom training and conferences should be more about tackling real life cases. But he admits things are the way they are for good reason.
CJ: Partly too why the education system exists the way it does is that it’s so efficient and easy. All you have to do is have some well known speaker stand up there and you’ve just entertained a thousand people in the audience, right? And these interactive approaches are much more labor intensive in general.
AM-T: But he says at his school, even in continuing medical education, they’re all about case-based learning. Everyone has to break into groups to discuss a case they’ve read about before class, and then each group reveals certain aspects of the case from the front of the room. He thinks that could easily happen at a medical conference.
CJ: So maybe it’s new management for HIV/AIDS and there’s a specific case the audience works through.
AM-T He’d love to see it happen.
AM-T: Do you feel strongly enough about it to propose it to anyone?
CJ: Well yeah, I think it’d be — we’re going to be doing it for conferences we set up for continuing medical education. So that’ll be a standard approach we take — there will be an expectation to review some didactic materials before coming and then bringing people together to work through cases in small groups in a larger room. So we’re doing it. But yeah I think it could work great in the conferences I go to, absolutely.
AM-T: Something else he’d like to see at future gatherings? Different groups of professionals all coming together.
CJ: The notion that we can all work in silos in healthcare is going away as we focus more on the patient, the person, if they’re sick, we recognize it’s not just about the provider, it’s about the team that cares for that person. And the solutions are much better when you bring in diverse perspectives.
AM-T: He says medical students now have to spend a certain number of hours during their four years with nurses, social workers, pharmacists, and engineers, all in training. He says that kind of collaboration will ultimately replicate itself at conferences, too, if the conditions are right.
CJ: If our conferences become more problem focused as opposed to more traditional discipline focused you’ll see these diverse groups coming together. Which I think is exciting and sort of mind opening.
AM-T: And it’s already happening at some events. I spoke to him right as South by Southwest was wrapping up in Austin. He says it’s quite a gathering – and one other conferences should aspire to.
CJ: That brings together an amazing array of people. You get kids still in school all the way to people post retirement, you get musicians and artists, you get politicians, you get physicians and social entrepreneurs to traditional entrepreneurs to venture capitalists. It’s the strangest and most wonderful diverse group of people and that is mind-opening in itself. It’s not distracting, it’s sort of a mad house actually, but a mad house in a really useful way.
AM-T: He says more conferences like that would be invigorating. That’s the Convene podcast for this time. There will be another show soon.
I’m Ashley Milne-Tyte. Thanks for listening.
Intro music composed by David McMillin