Early in their residencies, Andrew C. Buelt, DO, and Joseph Weatherly, DO, realized the importance of following the latest medical literature and updates. As family medicine residents, the pair saw patients with a wide variety of conditions, and they had to learn the treatment guidelines for these illnesses quickly.
But Drs. Buelt and Weatherly learned that treatment guidelines are constantly changing and not always based on the latest medical studies. For instance, they read guidelines suggesting that women age 65 should begin receiving bone density scans for osteoporosis every two years. But when they did some digging, they came upon studies that showed frequent follow-up bone density scans don’t predict fractures well or benefit patients.
When Drs. Buelt and Weatherly had a few more experiences like this, they decided to share their quests for knowledge with others. In early 2014, they began producing a biweekly podcast called Questioning Medicine that is dedicated to chronicling their own medical questions—and their search for answers.
“As a doctor, I can’t just be a vending machine of medications and tests that other people think are good to give out,” says Dr. Weatherly, who is a third-year family medicine resident at St. Petersberg (Florida) General Hospital. “I need to take some personal responsibility to find out why I’m giving these. And I don’t mean just reading abstracts and guidelines. I mean reading the research that they’re based on.”
Questioning Medicine podcasts are 30 minutes long on average and attract roughly 100 listeners every day, Dr. Buelt says. Episodes cover a wide range of medical topics, including vitamin D intake, diabetes and Tamiflu. In each episode, the pair discuss current treatment guidelines, new research and their advice for physicians and patients.
Drs. Buelt and Weatherly regularly advise patients to ask clinicians for more information on a given medication’s risks and benefits, and for doctors to provide that information to them. But to adequately provide patients with information, physicians need to know it well themselves, Dr. Buelt says.
“I’m hoping physicians will hear our podcast and be encouraged to read on their own. The literature is out there and the evidence is out there, but you have to be willing to read it and look for answers,” says Dr. Buelt, a second-year family medicine resident at St. Petersberg General Hospital.
Producing Questioning Medicine has changed the way Drs. Buelt and Weatherly practice medicine, they attest.
For instance, Dr. Weatherly says he once thought lab results were the most important component of a patient’s annual physical exam. But through his research, he learned that most patients don’t benefit from an annual EKG. He also learned that the U.S. Preventive Services Task Force does not recommend digital rectal exams, which many physicians still consider to be a routine annual procedure for men.
“I realized that the most important part of the annual visit is the conversation,” he says. “The conversation is what’s most likely to change the patient’s life and improve his or her health.”
Dr. Weatherly acknowledges that hard evidence doesn’t exist to support his opinion. Conducting a study on patient conversation versus labs would be extremely difficult, he says. However, physicians typically garner info from conversations that standard labs won’t give them, he notes.
“You’re developing a relationship, which is the forgotten part of medicine,” Dr. Weatherly says.
Through discussions with their patients, physicians have the opportunity to encourage healthy habits such as exercising and avoiding cigarettes. For instance, when physicians advise their patients on smoking cessation, they are more likely to successfully quit, according to a 2008 Center for the Advancement of Health review of studies. Physicians can also prescribe exercise; numerous studies suggest regular exercise has extensive health benefits and in many cases can reduce the risk of heart attack and stroke at least as much as blood pressure medication or statins.
Find a mentor
For those who are interested in firing up their own podcasts, Drs. Buelt and Weatherly suggest seeking out a mentor.
“Find somebody who’s already doing it, and just ask him or her questions,” Dr. Buelt says.
Before launching their podcast, Drs. Buelt and Weatherly sought feedback from James McCormack, PharmD, who cohosts the Best Science Medicine podcast, which also covers the practice of medicine. Dr. McCormack counseled the pair on microphones, editing apps and their logo. Later, Questioning Medicine hosted Dr. McCormack as a guest on an episode about diabetes.
“It’s great that a couple of young guys like Joe and Andrew are trying to make an impact,” Dr. McCormack told The DO. “One way to do that is to build up a listenership and disseminate information in an evidence-based fashion. They do a very solid job of that.”
The residents’ inquisitive nature is among their greatest strengths as podcast hosts, Dr. McCormack notes.
“They question things, and they are able to bring their day-to-day experience to the podcast,” he says. “They put it in a context that is very valuable to people who are at the same stage in their careers.”