How to Keep Up With Medical Literature in the 21st Century

"One of the commonest complaints of practicing physicians is their difficulty in keeping up with medical literature." – Nathan Flaxman, MD

Remarkably, this quote was published contemporaneously with the Supreme Court decision to ban racial segregation in public schools – the year was 1954, and there were over 800 articles published on cardiovascular topics that year!

Incidentally, the flagship journal of our own organization – the Journal of the American College of Cardiology – publishes a similar number of articles annually, and this completely ignores other prominent sources and the pantheon of subspecialty literature. Hence, Dr. Flaxman's advice from an earlier era on how to stay current may sound quaint: "Basically, all that is required is the current issue of the Journal [of the American Medical Association], an easy chair, pencils, a pad of paper and postal cards, along with a genuine, sustaining interest in all fields of medicine." He goes on to suggest handing a list of interesting articles to your secretary who will borrow the relevant journals or send for reprints.

Assuming you already possess a "genuine, sustaining interest" in cardiology, you already have a plan to stay abreast of the medical literature. It might be a topic alert e-mail service or perhaps you regularly listen to the podcasts by Valentin Fuster, MD, PhD, MACC, while on your way to and from work. Your mail carrier is almost certainly delivering at least one print journal. Regardless, I would encourage you to consider yet another tool – social media, particularly Twitter.

Right now I'm sure you're thinking: "I'm too busy."

My response: "Exactly."

In the time you spend in line at the café, you can scan the latest news in cardiology (no more than 140 characters) frequently with hyperlinks to the primary source. Microbursts of data are presented in real time and are immediately disseminated and dissected. It has been more than a decade since its humble inception and Twitter is now ubiquitous in our society. More importantly for cardiologists, Twitter has pivoted from just another social network into an information network. Politicians, industry leaders, and social entrepreneurs recognize its utility and are engaged. However, most physicians have responded with a shrug. Our reluctance stems from over-committed schedules, an assumption that tweets are "pointless babble" and pose reasonable privacy concerns. I, myself, only recently became a convert after attending this year's Legislative Conference (#ACCLegConf).

Why should Early Career cardiologists think about joining Twitter? Twitter allows me to keep a finger on the pulse of cardiology. Here's how: I follow professional organizations – including the ACC (@ACCinTouch) – reputable journals and respected peers/mentors.

Want to know the latest on the Medicare Access and CHIP Reauthorization Act (#MACRA)? Learn about it from @Cardiology, ACC's advocacy Twitter handle. Prevent yourself from being scooped by the residents when an important trial is published in the New England Journal of Medicine by following @NEJM. Need to keep up with the latest information for your fantasy football team? I can't help you, but I'm sure Twitter can (#fantasyfootball).

Now, if you're like me, you probably signed up for an account some years ago and have forgotten your password. Retrieve it (or sign-up). Consider reviewing a Twitter tutorial – a quick Google search will find several tailored to physicians. Next, start following someone or something – @JACCJournals, the official handle for studies published in all six of the JACC Journals, is a conservative choice. Finally, share something that piqued your interest – and don't forget to use hashtags so your comments can be curated and searchable. Summarized below is a brief to-do list for the Twitter novice (from an acolyte):

  1. Take the plunge: Sign-up or retrieve that forgotten password.
  2. Introduce yourself: Tweet @north_noelck and add #ImACardio.
  3. Learn something: Follow thought leaders in the field.
  4. Share something: Post relevant content. There are a variety of ways to shorten website URLs. Again, tutorials exist on the web and there's also an app for that.
  5. Never post patient information or offer individual patient advice. Add this line (or something similar) to your Twitter bio: All opinions are my own.

My experience is that Twitter can serve as an enjoyable way to stay connected with your colleagues and provide some peripheral vision so you are not broadsided by a trending topic. That said, when it comes to a serious dedication to the literature, Dr. Flaxman's recommendations still hold water.

This article was authored by North Noelck, MD, MPH, a cardiologist with the Veterans Affairs Portland Health Care System.