Date:  May 27th, 2014

Guest Skeptic: Dr. Joe Lex. Many consider Dr. Joe Lex the Godfather of the FOAM (Free Open Access to Medication) movement. Dr. Lex is a Professor of Emergency Medicine at Temple University. His site called Free Emergency Medicine Talks has over 2,300 MP3s of lectures. It is an unbelievable global and free resource for anyone interested in emergency medicine. Dr. Lex has been inspiring the next generation of emergency physicians for years.

Dr. Lex has been referred to as the godfather of the FOAMed movement. Everyone in the FOAM community should be familiar with Joe’s famous quote. Dr. Lex recently took part in a PRO/CON debate in EP Monthly with Dr. Nick Genes. His PRO side was titled Why #FOAMed is Essential to EM Education while Dr. Genes argued Why #FOAMed is NOT Essential to EM Education.

We covered the CON side of this debate in SGEM#72: Tiny Bubbles (#FOAMed and #MedEd). Dr. Lex was contacted to respond. He provided a sound clip of his famous quote doing a great impersonation of Marlon Brando Godfather character (FOAM Godfather).

Dr. Lex and I reviewed the concerns raised by Dr. Genes:

  1. Students and physicians would overdose on FOAM
    • FOAM is essential but maybe not as an exclusive source for medical students and residents
    • Need to know the basics and FOAM can build on the fundamental knowledge base
    • Mentions Boring EM, EM Basics and Emergency Medicine Abstracts
  2. Quality of FOAM and difficulty referencing the material
    • Dr. Fox effect
    • Ability to reference the FOAM is a trivial matter
  3. FOAM is not a curriculum
    • Not yet but it is coming
    • WikiEM is the closest thing to date
    • Life in the Fast Lane is pretty good
  4. Learners have limited time so should use other more traditional resources
    • Depends on individual learning styles
  5. FOAM could make people intellectually lazy and not dive deeper into the literature
    • We do that all the time when reading summary articles and meta analysis
    • Not intellectually lazy but rather intellectually efficient

We then expanded on Dr. Lex’s famous quote:

  • If you want to know how we practiced medicine 5 years ago, read a textbook.
    • FOAM is like lego for the brain that can fill in the gaps of knowledge that are already there
    • FOAM can not substitute for a text book yet but WikiEM may ready in 2-3 years
  • If you want to know how we practiced medicine 2 years ago, read a journal.
    • Might be a little exaggerated, especially with pre-publication on line now
    • There still is a lag time due to the peer review process
  • If you want to know how we practice medicine last year, go to a (good) conference.
    • Only a handful Dr. Lex considers good (ICEM, AAEM and SMACC)
    • I am biased towards CAEP and BEEM conferences
  • If you want to know how we practice medicine now and in the future, listen to the conversations in the hallway and use #FOAMed.
    • Twitter is an absolutely phenomenal tool
Leaf from Tree of Hippocrates

Leaf from Tree of Hippocrates

Final Thoughts: Dr. Lex is very jealous about the next generation of medical educators who have embraced FOAM. Hippocrates was talking about free open access to medical education in his oath. Dr. Lex has a leaf from the tree of Hippocrates from the town of Kos. It is under this tree Hippocrates taught the art of medicine for free to his students.

KEENER KONTEST: Last weeks winner was Chris Belcher from the University of Kentucky College of Medicine. Chris got all three answers correct about azithromycin.

  • Discovered in 1980
  • Patented in 1981
  • Discovered by Croatian Dr. Slobadan Dokic’s team

Listen to this weeks podcast for the Keener question. If you know the answer then send your answer to TheSGEM@gmail.com with “keener” in the subject line. Be the first one with the correct answer and I will send you a cool SGEM skeptical prize.

Remember to be skeptical of anything you learn, even if you heard it on The Skeptics’ Guide to Emergency Medicine.