The Influence of Early Ophthalmic Hospitals on the Journal.

PURPOSE: To consider the American Journal of Ophthalmology's (AJO's) role not only as a forum to describe clinical and scientific advances but also as a record of institutional histories. We used the New York Eye and Ear Infirmary of Mount Sinai, the Massachusetts Eye and Ear Infirmary, and the Wills Eye Hospital as case studies on the Journal's role in documenting the people and organizations that have moved ophthalmology forward. DESIGN: Perspective. METHODS: Using the ScienceDirect database, we conducted a literature search to gather all mentions of the 3 eye hospitals in the Journal's archives from 1918 to 2018. We evaluated those search results to identify a few of the individuals and articles that highlight how the history of eye institutions are reflected in the AJO. RESULTS: Searches for the aforementioned 3 hospitals yielded over 3400 results in Journal archives. These included articles on their histories, proceedings from clinical case conferences, profiles of prominent surgeons, and information about educational offerings, among others. Many of those articles were written by physicians from those institutions who also served on the AJO's editorial board or had a long history of publishing in the Journal. CONCLUSIONS: The AJO has played a crucial role in the last 100 years as a register of ophthalmic history. The New York Eye and Ear Infirmary of Mount Sinai, Massachusetts Eye and Ear Infirmary, and Wills Eye Hospital provide 3 examples of how that role manifests.

Addressing Student Burnout: What Medical Schools Can Learn From Business Schools.

Although they enter school with enthusiasm for a career in medicine, medical students in the United States subsequently report high levels of burnout and disillusionment. As medical school leaders consider how to address this problem, they can look to business schools as one source of inspiration. In this Invited Commentary, the authors argue-based on their collective experience in both medical and business education-that medical schools can draw three lessons from business schools that can help reinvigorate students. First, medical schools should offer more opportunities and dedicated time for creative work. Engaging with diverse challenges promotes intellectual curiosity and can help students maintain perspective. Second, schools should provide more explicit training in resiliency and the management of stressful situations. Many business programs include formal training in how to cope with conflict and how to make high-stakes decisions, whereas medical students are typically expected to learn those skills on the job. Finally, medical schools should provide better guidance on practical career considerations like income, lifestyle, and financial skills. Whether in medicine or business, students benefit from open discussions about their personal and professional goals. Medical schools must ensure that students have an outlet for those conversations.

Leadership in Ophthalmology: The Role of Physician-MBAs.

PURPOSE: As American health care evolves, an increasing number of doctors are pursuing MBAs. However, relatively little is known about how business training translates into their future careers. This study characterizes ophthalmologists who have completed MBAs and identifies opportunities for physician leadership in the field. DESIGN: Cross-sectional study. METHODS: We identified 120 ophthalmologists who hold MBAs. We searched each individual's online profiles to collect information on demographics, training, and professional activities. RESULTS: Physician-MBAs in ophthalmology are 80% male; 80% are fellowship trained; and 28% are in primarily nonclinical roles and 55% participate in significant nonclinical activity. Hospital administration is most common (31%), followed by pharmaceutical administration (7%) and consulting (5%). Older ophthalmologist-MBAs were more likely to work in nonclinical roles, with 79% of those who completed residency before 2000 engaged in significant nonclinical activity compared to 30% of those who completed residency after 2000. The most common employers of physician-MBAs in ophthalmology are academic medical centers (43%), large group practices (30%), and private practices (13%). CONCLUSIONS: The majority of ophthalmologist-MBAs work in primarily clinical roles, although a sizable proportion hold nonclinical positions. Moving forward, we anticipate an increased role for physician leaders in health care administration, policy, and entrepreneurship. While formal management training is not necessary for these roles, a growing number of physicians have sought out MBAs to support their nonclinical interests.

Representation of health conditions on Facebook: content analysis and evaluation of user engagement.

BACKGROUND: A sizable majority of adult Internet users report looking for health information online. Social networking sites (SNS) like Facebook represent a common place to seek information, but very little is known about the representation and use of health content on SNS. OBJECTIVE: Our goal in this study was to understand the role of SNS in health information seeking. More specifically, we aimed to describe how health conditions are represented on Facebook Pages and how users interact with these different conditions. METHODS: We used Google Insights to identify the 20 most searched for health conditions on Google and then searched each of the resulting terms on Facebook. We compiled a list of the first 50 Facebook "Pages" results for each health condition. After filtering results to identify pages relevant to our research, we categorized pages into one of seven categories based on the page's primary purpose. We then measured user engagement by evaluating the number of "Likes" for different conditions and types of pages. RESULTS: The search returned 50 pages for 18 of the health conditions, but only 48 pages were found for "anemia" and 5 pages were found for "flu symptoms", yielding a total of 953 pages. A large number of pages (29.4%, 280/953) were irrelevant to the health condition searched. Of the 673 relevant pages, 151 were not in English or originated outside the United States, leaving 522 pages to be coded for content. The most common type of page was marketing/promotion (32.2%, 168/522) followed by information/awareness (20.7%, 108/522), Wikipedia-type pages (15.5%, 81/522), patient support (9.4%, 49/522), and general support (3.6%, 19/522). Health conditions varied greatly by the primary page type. All health conditions had some marketing/promotion pages and this made up 76% (29/38) of pages on acquired immunodeficiency syndrome (AIDS). The largest percentage of general support pages were cancer (19%, 6/32) and stomach (16%, 4/25). For patient support, stroke (67%, 4/6), lupus (33%, 10/30), breast cancer (19%, 6/31), arthritis (16%, 6/36), and diabetes (16%, 6/37) ranked the highest. Six health conditions were not represented by any type of support pages (ie, human papillomavirus, diarrhea, flu symptoms, pneumonia, spine, human immunodeficiency virus). Marketing/promotion pages accounted for 46.73% (10,371,169/22,191,633) of all Likes, followed by support pages (40.66%, 9,023,234/22,191,633). Cancer and breast cancer accounted for 86.90% (19,284,066/22,191,633) of all page Likes. CONCLUSIONS: This research represents the first attempts to comprehensively describe publicly available health content and user engagement with health conditions on Facebook pages. Public health interventions using Facebook will need to be designed to ensure relevant information is easy to find and with an understanding that stigma associated with some health conditions may limit the users' engagement with Facebook pages. This line of research merits further investigation as Facebook and other SNS continue to evolve over the coming years.