Dr. James McCormack is one of a handful of faculty members at the University of British Columbia who uses podcasts (see example) as a way to share information with pharmacists and physicians around the world. James has considerable experience talking in straightforward terms to health consumers as well as medical professionals about the rational use of medications. James always infuses his presentations with humour (to which I can attest) as well as the best evidence and rational therapeutic principles.
1. For those unfamiliar with the Therapeutics Education Collaboration (TEC), can you give my readers an overview of your site, who is involved and who your target audience is, and what role your site fulfills.
“The best way to describe us is that we are the “Mythbusters” of drug therapy. Put simply, our goal is to provide physicians, pharmacists, nurses, nurse practitioners, physician assistants, other health professionals, and the public with current, evidence-based, practical and relevant information on rational drug therapy.
One of the main jobs for clinicians is to filter and contextualize information for patients. To do this they need reliable/credible sources of evidence-based synopses – and most available guidelines do NOT fill that role. Clinicians also need to have simple-to-use tools that allow them to make risk estimations so they can describe the overall risks and benefits of therapy. Finally, they need to be allowed to practice the ART of medicine and NOT be incentivized to reach surrogate “targets”.
To facilitate this, I, and an excellent evidence-based family doctor called Mike Allan, have been recording weekly podcasts on a variety of different topics for over a year. Thanks to our listeners, we have become one of the most popular medical podcasts on the web. We try to keep the information provided in our podcasts practical and relevant so clinicians can incorporate this information into their day-to-day practice. Humour, because evidence can be really dull, plays an important role in all our presentations. Most importantly we are strong advocates of shared-informed decision-making and our podcasts try to provide information and tools and ideas in a way that can easily be used to communicate with patients. Much of our information comes from Cochrane reviews, meta-analyses, and the excellent material produced by the Therapeutics Initiative at www.ti.ubc.ca .”
2. You do a lot of work with social media, and especially podcasts. Can you tell me a little bit about the use of podcasting on your site and why you use that tool to communicate?
“While we do live presentations every year to hundreds of clinicians, it is impossible to get regular and up-to-date messages out to a large number of people by doing live face-to-face presentations. In addition, many people only have intermittent times during a day or a week to get “caught up” on what is happening so podcasts provide an excellent format for dealing with quick, mass dissemination of information and on-demand content.”
3. How do you stay current in evidence-based practice? Do you have some tips you can share?
“I stay current by subscribing to RSS feeds for the 10 or so top medical journals, and use daily POEMs as well. I have set up some Google alerts for a number of topics, and subscribe to e-mail services like MedPage Today. My main approach to reviewing the medical literature is to remember that typically the story or the abstract presents information in the best possible light. If I read an abstract of something and it does not encourage me to consider changing my practice, I don’t read any further.
Most importantly I use the following “Coles Notes” approach to skeptical thinking.
UNTIL PROVEN OTHERWISE I ASSUME THAT:
1) When I read a clinical trial the conclusion is wrong
2) When I review a patient’s medication history the drugs and the dose they are taking is wrong
3) When considering ordering a clinical test, the test is not needed
4) When reviewing clinical practice guidelines most recommendations are opinion-based, not based on data from well-designed RCTs and do not apply to my patient’s values
5) Finally, when a new drug comes out it provides no advantages over what is already out there.
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4. Anything else you want to tell folks?
“When it comes to medicine, we need to remember we are trying to treat disease not create dis-ease. I strongly believe the following are not associated with an increased quality of life.
1) Telling an asymptomatic person they have a “disease”
2) Discussing lipids/BP/glucose/BMD/salt with anyone
3) Worrying about your/someone’s cholesterol/BP/glucose/BMD
4) Sitting around at dinner discussing the different types of fat or the glycemic index of foods.
We obviously need to eat healthy foods but a huge part of life is enjoying the foods we eat. We obviously need to have regular routine of healthy eating and exercise – but again these activities have to be things we enjoy.”
Dr. McCormack’s Podcasts:
The Therapeutics Education Collaboration (TEC) can be found at http://therapeuticseducation.org/
and the link via itunes is: http://phobos.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?id=279020839
Dr. James McCormack can be reached at: jmccorma@interchange.ubc.ca
Yvonne Chan
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