Pracha Eamranond, MD
- Certified by the American Board of Internal Medicine
- Chief Medical Officer, Doctorpedia
- Attending Physician, Brigham & Women’s Hospital
- Assistant Professor, Harvard Medical School
Dr. Pracha Eamranond has been a chief medical officer in small and large healthcare organizations focusing on patient experience and education. He currently teaches at Harvard Medical School and cares for patients with complex medical and psychosocial issues at Brigham and Women’s Hospital. He has been invited to speak at national and international conferences on patient and physician experience as they navigate medical information via online resources. He has been an editor for UpToDate, principally managing primary care and hospital medicine. Dr. Pracha understands the challenges we all face every day in managing health with limited access to high quality medical information. His work in quality improvement, clinical care, management, research, and teaching have led to improved patient experience and overall quality of care.
May 20, 2020
Doctorpedia Chief Medical Officer Dr. Pracha Eamranond talks about what led him to internal medicine and population health, how to protect against COVID-19, his love for tango, and more.
- Growing up in Bangkok, Thailand and California and how those experiences informed his passion for fighting inequity and distribute healthcare access to everyone
- The US’s response to the COVID-19 pandemic and how we can protect ourselves and each other from infection
- His love for tango and how he and his wife continue to dance every day
- His role as Chief Medical Officer for Doctorpedia and previous companies like UpToDate
- How teaching at Harvard University and working at Brigham Women’s Hospital have allowed him to learn from so many brilliant people and have access to top technology and minds
- How he’s excited about the prospect of Doctorpedia utilizing video and emerging technologies to share healthcare resources and information with the public
- How he stays healthy with dancing, meditation, biking, and other activities
- “Unlike the influenza of 1918, we have a lot more ability to share information readily across country lines, across a neighborhood. I believe that we should be prepared and really understand where it is that we can get information to manage our behaviors in a way that minimizes our risk to COVID-19.”
- “Whenever we go anywhere when we travel, we look for a couple of things – we look for tango and we also look for pho, which is Vietnamese noodles.”
- “Doctorpedia has taken that stance that – in video format particularly – we can all understand somewhat easier how we take a complicated issue such as healthcare.”
- “I’ve been teaching at Harvard now for 15 years. I love the place. I went there for a reason. I feel as though I’m at one of the centers of learning – and I do believe that there’s a lot of amazing places out there to learn – and I’ve learned so much about medicine, about people from different places.
- “I’ve had a lot of my own patients tell me, ‘this is scarier than a bombing or an invasion of troops’ – just because this is so foreign for us. In our lifetimes we haven’t had to deal with this. Even though some folks expect epidemics and pandemics every so often – this is the first time in our generation that we’re dealing with such an enemy as COVID-19.”
- “It’s nice to see a place like Doctorpedia where it can inform the general public about a lot of new technologies that are coming out that impact healthcare. The sooner we get everyone on the same page, I think the better it will be for the health and clinical outcomes for folks around the world.”
I think that's probably the hardest part in today's world, given all that's going on is: how do we evenly distribute access to healthcare? Particularly since many of us experience our own health in different ways and some of us are healthier than others, that differential of how to provide care to different types of people with different levels of need is challenging. But certainly we can do it.
Pracha Eamranond, MD
One thing I try to do every morning is meditate and that automatically resets my mind so that I have more clarity throughout the day and settles a lot of the emotions that I go through.
Pracha Eamranond, MD
I still practice internal medicine as a primary care physician and as a hospitalist position, but I also spent a lot of my time on what we call population health, which is improving the experience for patients, improving clinical outcomes for patients while reducing cost. And so that is what we generally call 'the triple aim'.
Pracha Eamranond, MD
Daniel Lobell: (00:00)
This podcast or any written material derived from its transcripts represents the opinions of the medical professional being interviewed. The content here is for informational purposes only and should not be taken as medical advice. Since every person is unique, please consult your healthcare professional for any personal or specific needs. Hi, this is Daniel Lobell with the Doctorpedia Podcast. On the line with me today I have Dr. Pracha. How are you, doctor?
Dr. Pracha Eamranond: (00:31)
Great, Danny. Thanks for inviting me to be here.
Daniel Lobell: (00:33)
Thanks for being here. I’m excited to talk to you and I’ve had the opportunity to look into some of your stuff and I’m going to be talking to you about that in just a minute. But let’s start at the beginning. You were raised in Bangkok, is that correct?
Dr. Pracha Eamranond: (00:48)
Right. I grew up for a few years in Bangkok, Thailand, and spent most of my childhood and teenage years in California.
Daniel Lobell: (01:00)
Okay. So how old were you when you moved to California?
Dr. Pracha Eamranond: (01:04)
I lived in Thailand on and off for six years or so and spent my childhood up until the end of high school in Southern California.
Daniel Lobell: (01:15)
Was it a culture shock going from one to the other?
Dr. Pracha Eamranond: (01:20)
It was just what I grew up with. So to me it was not something that was shocking, per se. My parents kind of raised us with the opinion that “you take what you get”.
Daniel Lobell: (01:37)
Dr. Pracha Eamranond: (01:38)
[Laughs] So, yeah. Psychologically it was never really a shock. It was just something I had to get used to. You know, clearly there’s huge differences between Southeast Asia and California. But my siblings and I, we transitioned pretty well and eventually – not right away – we learned to appreciate the difference between both cultures, particularly since it made us very different people.
Daniel Lobell: (02:08)
Dr. Pracha Eamranond: (02:11)
Well, I can’t say that I grew up in poverty, but my parents certainly did. And to see where they were raised on the streets of Bangkok and talk about their struggles with food and health, which is a totally different environment than many of us grow up with in the United States, made us into different people so that we could appreciate things in a different way. And, as you know, there’s plenty of poverty and disease to go around in the United States, but certainly not to the extent as other parts of the world.
Daniel Lobell: (02:50)
I imagine that probably played a huge role in your decision in wanting to be a doctor. Right?
Dr. Pracha Eamranond: (02:57)
Yeah. Eventually. You know, growing up and seeing poverty – in the beginning, I was kind of enthralled with business. That’s what my parents got into when they came to the United States. They worked their way up and eventually owned their own business and made the American dream out of their lives and gave us a lot of opportunities that we wouldn’t have had otherwise. So initially I was interested in making a lot of money but pretty quickly I started to see that that disparity even in East LA where we grew up – we hopped around a bit, but I would see… you needed metal detectors to get into my school. And there were a lot of gangs, lots of violence. And so with that disparity, it made me think differently about going into the business world to make money and rather trying to focus on how do we fight against inequity and make sure that – as best we can, anyway – you distribute healthcare in a way that’s equitable and feasible. Because I think that’s probably the hardest part in today’s world, given all that’s going on is: how do we evenly distribute access to healthcare? Particularly since many of us experience our own health in different ways and some of us are healthier than others and so that differential of how to provide care to different types of people with different levels of need is challenging. But certainly we can do it.
Daniel Lobell: (04:45)
Definitely a hot topic nowadays, right? It’s something we hear about all the time is the idea of universal healthcare versus private healthcare and it seems like you were thinking about it even as a kid.
Dr. Pracha Eamranond: (05:00)
Right. And take that a step further with COVID-19 now. The distribution of the disease is vastly different than what one might expect in terms of the developed countries being disproportionately affected by the virus compared to developing nations.
Daniel Lobell: (05:22)
Right. Yeah. So when people talk about where we’re at with COVID-19 versus China, are we ahead of the curve? I mean, it’s so hard for me to see as just a person watching TV. Are we doing better? And if so, how so?
Dr. Pracha Eamranond: (05:42)
So that’s a really awesome question. It depends on what vantage point you’re taking to be able to answer that question. You know, in certain ways we’re better in some ways we’re not. Clearly China has been overcoming that hump you and releasing a lot of the restrictions it imposed when they started and we’re at the other end of the spectrum where we’re we’re seeing more cases, more deaths, and so we’re going to respond to it in a completely different way in terms of escalating our restrictions. So it’s quite complex in terms of what’s going on on the ground between both countries and actually, you know, looking at a lot of other countries. I’ve had the fortunate (or misfortune) of traveling quite a bit during the last few months. And so you see how the responses vary considerably between different countries – even within the same country, like the United States – based on geography and based on the timing of how things are unfolding.
Daniel Lobell: (06:53)
So where are we at an advantage other than on the timeline, medically speaking? Are we better equipped to handle things? Do we have – because of the fact that I assume we have more cleanliness already instituted into our culture – is that helping us?
Dr. Pracha Eamranond: (07:16)
Right. So, that’s another great question.
Daniel Lobell: (07:21)
Dr. Pracha Eamranond: (07:21)
The way that COVID is being transmitted and how we’re responding to it is variable state by state and COVID-19, as we know, can be lethal and it’s a very important factor that we don’t have immunity to COVID-19. So it’s a relatively new thing in comparison to influenza and other viruses. So the US healthcare system, just like a lot of other healthcare systems, are not necessarily best equipped to manage this particular virus. Now, taking a step back, it is quite remarkable what the United States has done for healthcare. You know, we’ve become a leader in healthcare. It used to be that other places in the world as recently as last century were dominating the healthcare landscape in terms of research and delivery of care. It used to be that places like Germany and France would come out with some of the latest in terms of technology, if you will, or medication around medical innovation. And now the United States has done that. So you can like in our current situation to wartime and we have a lot of advanced capabilities in terms of being able to manage a war, just like were able to manage disease. Whether you’re talking about a theater of war or a surgical theater, we have a lot of knowledge, a lot of research and frankly just a lot of capacity. The concentration of hospitals and physicians in the United States is remarkable if you compare it to other parts of the world, like Sub-Saharan Africa, parts of Southeast Asia, and South America. So you would expect us to be very, very well prepared to manage any sort of catastrophe and some of the best universities, for example, in the world are in the United States. However, when you look at the conditions on the ground, we are not able to control COVID-19 like one might expect. Currently there are severe outbreaks in various parts of the United States, particularly right now in New York. Even though there’s a lot of wealth, there are great hospitals, wonderful physicians, wonderful healthcare staff in New York – the ability to manage COVID-19 is limited. You know, because we have not fought this battle before. We are doing our best to mobilize troops, mobilize ventilators, mobilize staff.
Daniel Lobell: (10:27)
Dr. Pracha Eamranond: (10:27)
But this is a very new world that we’re living in
Daniel Lobell: (10:30)
Calling it a “war”. I mean it’s interesting, I hear that a lot on TV as well. It’s almost a war that I don’t know how to fight. They just tell you to stay home to fight, you know? And your only weapon is hand sanitizer.
Dr. Pracha Eamranond: (10:43)
Daniel Lobell: (10:43)
It’s almost like there is a part of me that wishes I could go into the battle and fight. But, I mean, you guys are the soldiers. The doctors are the soldiers. We’re just basically relying on you.
Dr. Pracha Eamranond: (10:58)
Right. You know, I think that’s when there is an epidemic of an infectious disease, you turn many times to physicians, to the government. And I’ve had a lot of my own patients tell me, “this is scarier than a bombing or an invasion of troops.” Just because this is so foreign for us. In our lifetimes we haven’t had to deal with this. Even though some folks, we expect epidemics and pandemics every so often – this is the first time in our generation that we’re dealing with such an enemy as COVID-19.
Daniel Lobell: (11:43)
Is there any advice you’d give people right now to build their immunity to stay safe?
Dr. Pracha Eamranond: (11:51)
So there are a lot of things. First off, you do want to – as you already referred to – you want to keep you and your family safe by staying at home and minimizing your exposure and that obviously will help protect others. There are a lot of things to be aware of in terms of wearing face masks, how to minimize exposure to foods that you eat, foods that you have access to, how do you interact with others? And I think that it raises a good point in terms of how do we educate ourselves now that we’ve turned into an online community?
Daniel Lobell: (12:37)
Dr. Pracha Eamranond: (12:37)
All of us – patients, physicians – are looking at the online world to see how do we learn about how to protect ourselves, how to protect others – in particular our loved ones from COVID-19? And so it’s an opportune time, I think, to see how we can leverage the intellectual wealth that’s out there. Unlike the influenza of 1918, we have a lot more ability to share information readily across country lines, across a neighborhood. I believe that we should be prepared and really understand where it is that we can get information to manage our behaviors in a way that minimizes our risk to COVID-19.
Daniel Lobell: (13:36)
You mentioned that it has to do with the food that we eat. Can you elaborate on that a little bit?
Dr. Pracha Eamranond: (13:43)
Right. Most of the time we’re talking about spread of viruses either through respiratory droplets or through contact with the virus on various surfaces. That includes, actually, the food we eat. So there’s been a lot of online discussion of what are the best ways to protect ourselves as we either go and pick up food or as we have it delivered to us, we want to make sure that whatever we’re touching doesn’t go directly into our mouths, that we have a way to sanitize the packaging and the food that we’re touching before it goes into our mouth. So just be extra careful about how you handle everything, but including food.
Daniel Lobell: (14:36)
There’s a push to support the local restaurants so they don’t shut down and order in from them. But I was thinking to myself, what if the person who is working at that restaurant has the virus? Can they pass it on to me through the preparation of that food? Is that to be concerned about?
Dr. Pracha Eamranond: (14:53)
Yes. It’s just like interacting with anyone else in front of you or within a building or a restaurant – if they touch something and if they actually have the virus, they can pass it off onto any given surface. Some surfaces are more likely to allow the virus to live longer, but there’s certainly a risk anytime you touch something that’s been touched by a person who’s actively infected.
Daniel Lobell: (15:26)
Dr. Pracha Eamranond: (15:26)
So there are real risks there and we just need to be particularly sensitive to those risks. As a physician in Boston, we’re seeing more and more people become infected. In fact, the hospitals now are a prime source where the employees are getting infected. It’s not just in the community. That makes sense because patients who have COVID-19 and who are very ill will have a higher burden of the virus. And when they’re in the hospital they can spread it to healthcare workers. So we ought to be pretty careful in how we interact with one another.
Daniel Lobell: (16:13)
Can you eat the virus? Can it be live on the food? And then you eat it and it you become infected?
Dr. Pracha Eamranond: (16:19)
Yes. Viruses, like I mentioned before, can live on anything for a certain period of time. And if someone who’s actively infected puts the virus on the food that you eat and you ingest it, that virus can go into your mouth. It doesn’t necessarily – once it goes through your gastrointestinal tract, it has a much harder time of living, right? Once it gets in your mouth, it doesn’t have to go into your gastrointestinal tract. It can go down to your lungs–
Daniel Lobell: (16:47)
It can just take a right turn or something? When the rest of the food is going down, it’s like, “I’ll see you guys later.” And then it goes to–
Dr. Pracha Eamranond: (16:53)
Right, it can be on your hamburger and suddenly it sticks to your mouth and then it moves its way down to your respiratory tract.
Daniel Lobell: (17:00)
Dr. Pracha Eamranond: (17:01)
Daniel Lobell: (17:01)
It’s almost like there’s so much you can do at a certain point and then it’s just like it’s in G-d’s hands. You know, I think you could put on gloves, you could put on a mask, but at a certain point it seems like there’s so many ways that you could get this that even if you’re super vigilant and careful, you could still fall victim.
Dr. Pracha Eamranond: (17:30)
That is true. That is true. So we can’t control everything, unfortunately, in life and viruses are one of them. We can control our behaviors, though. So as we were alluding to before, if we minimize our contact with folks who are infected with the virus, clearly that’s of the best ways to prevent spread.
Daniel Lobell: (17:51)
All right, let’s change it up for a second and lighten the tone. One of the things that I thought was particularly fascinating when I was looking into your blog and doing a little back research on you was your love for the tango, which I imagine right now would also be a risk for getting COVID-19, because it does take two to tango, correct?
Dr. Pracha Eamranond: (18:16)
That is correct.
Daniel Lobell: (18:18)
And there’s not six feet of separation between two tango-ers, but let’s look to an optimistic future when people can tango again and maybe you can share your love and passion for the tango with my listeners here.
Dr. Pracha Eamranond: (18:32)
Right, right. You know, I used to call it a love and a passion, but clearly now I think of it as a way of life. So you are absolutely correct. The tango is a risky behavior in terms of dancing with someone else, particularly if they have COVID-19. However, I continue to dance every day with my wife. We have been together – as of today, actually – for 15 years in marriage.
Daniel Lobell: (18:59)
Dr. Pracha Eamranond: (18:59)
Thank you. Thank you. We’re very happy. And when we dance in our house, we know that because we haven’t interacted with anyone else outside the house, we still manage to keep social interaction within our neighborhood and we talk from afar, but I know my wife is perfectly safe to dance with. So we do keep that connection. And we have a long history of dancing. We met when we were studying at Yale and we were out at the club dancing salsa and we later, shortly thereafter, we knew we both loved tango. And after I was finishing residency and my wife was finishing her PhD, we took a year off just to dance tango and we went down to Argentina. That’s how – we call it “fievre de tango” – tango fever. So we really had it bad.
Daniel Lobell: (20:04)
Tango fever is not a sign of COVID-19, correct? [Laughs]
Dr. Pracha Eamranond: (20:08)
It is not. It is not. But you can get sick with tango fever, certainly. We had it pretty bad.
Daniel Lobell: (20:19)
Would you describe it as a pandemic? [Laughs]
Dr. Pracha Eamranond: (20:21)
It is! It is a pandemic. The history of tango is fascinating. It started in the late 19th century in Argentina and it almost died out in the 20th century but thanks to a lot of talented musicians and others, it has had a resurgence and it’s danced all over the world. Whenever we go anywhere when we travel, we look for a couple of things – we look for tango and we also look for pho, which is Vietnamese noodles. It’s surprising how you can get connected with folks, particularly through tango. And we were a few weeks ago back in Argentina and the Coronavirus had already been hitting many parts of the world and you could see the fear and it’s really mind boggling to see. But the fear where we were at in Buenos Aires was the fear of not dancing. The fact that the Coronavirus would eventually close down the “Milongas” or the places where we dance tango.
Daniel Lobell: (21:51)
–Which I learned from your short film that Milonga is also the name of a dance. Right?
Dr. Pracha Eamranond: (21:56)
It is! It is. So the fact that Coronavirus could just shut us down is scary, obviously. Not only because of the health implications, but because of the social connectedness that has been lost since the Milongas were all shut down from Coronavirus.
Daniel Lobell: (22:13)
Now you can look at those people who go diving with great white sharks and say, “you think what you do is dangerous? I tango.”
Dr. Pracha Eamranond: (22:20)
[Laughs] Right, right, right. So tango is not without risk, that’s for sure.
Daniel Lobell: (22:28)
Now if I were to touch a surface where somebody who tangos had touched the surface within an hour, could I pick up this tango fever? [Laughs]
Dr. Pracha Eamranond: (22:39)
You could, you could. The scary part again about tango is that in Argentine tango, you’re chest to chest, so you’re right up face to face with your partner. It’s unlike ballroom tango or ballroom or the other social dances like salsa swing where you’re touching with just your hands and you’ve got a few feet in front of you. You are literally against each other. So you’re sharing quite a bit of contact and certainly, infectious diseases could theoretically spread much more quickly given the degree of contact you have when you’re dancing.
Daniel Lobell: (23:18)
Yeah. Now is your wife herself Argentine?
Dr. Pracha Eamranond: (23:23)
My wife is from Columbia, but interestingly enough, one of the largest hubs of tango outside of Argentina is in Columbia. And so there was a very famous tango singer and composer named Carlos Gardel who died in Columbia and there was a very rich history and love for tango music, which where my wife became enthralled with tango.
Daniel Lobell: (23:50)
Wow. It’s such a cool thing that you have this connection. Most people who have something in common in the marriage, it’s not as interactive, I would think.
Dr. Pracha Eamranond: (24:02)
Yeah. Yeah. What we love about tango is that we met dancing salsa. So we were young, in our twenties, and pretty surely after we met we started realizing, “hey, we’re kind of old” and we were in our twenties! You’ve got a lot of young people out there dancing, schmoozing, and they were there to clearly pick up on each other. And when you go dance tango, it’s a much more mature crowd. It was actually cool when you go to Argentina, the best dancers are in their seventies, eighties – you don’t have to do fancy moves, you really just have to be connected.
Daniel Lobell: (24:38)
Dr. Pracha Eamranond: (24:38)
So, yeah – my wife jokes with me all the time: she loves dancing with Argentine men who particularly have a pot belly cause you feel the connection more.
Daniel Lobell: (24:54)
Dr. Pracha Eamranond: (24:54)
Those are her words, anyway. And folks who have a lot more experience, who tend to obviously be older because they’ve had years of dancing experience. It’s a very different vibe, a very different ambience to be dancing tango compared to other dances.
Daniel Lobell: (25:13)
Absolutely. So let’s go back to talking medicine again. What is your specialty in medicine?
Dr. Pracha Eamranond: (25:24)
So I trained as an internist and I did an internal medicine residency at Yale in New Haven, Connecticut. And after that I did a general internal medicine fellowship, or faculty development fellowship at Harvard Medical School, where I focused on research epidemiology and then when into full time research editing. And now I still practice internal medicine as a primary care physician and as a hospitalist position, but I also spent a lot of my time on what we call population health, which is improving the experience for patients, improving clinical outcomes for patients while reducing cost. And so that is what we generally call “the triple aim.” There’s also the “quadruple aim”, which is really making sure that staff, physicians, and clinicians are also experiencing satisfaction in what they do for work. So trying to improve it all, you know? Because with any one prong of those four aspects, it’s really tough to make a health system successful.
Daniel Lobell: (26:51)
Right. And that’s actually a perfect lead in for my next question. I know you recently joined Doctorpedia as the Chief Medical Officer. Can you talk a little bit about your role in that and what you hope to accomplish in that capacity?
Dr. Pracha Eamranond: (27:08)
Right. So the Chief Medical Officer role varies in different places. And I’ve been a chief officer for various organizations at this point, but Doctorpedia is just such an exciting company to work with right now because it’s taking a different path towards educating folks out there about health. So Doctorpedia is traditionally focused on educating patients, which is amazing. There’s thousands of resources available, particularly in video format, in Doctorpedia. And now we’re looking to see how we expand the breadth of what Doctorpedia does into making sure that we are also educating physicians and organizations on healthcare. Given that there’s more knowledge that’s coming out than we could possibly digest, we do need people who are able to curate that medical knowledge. I used to work for a company called UpToDate, which provides health information to physicians around the world. A lot of physicians around the world find it hard not to have UpToDate when they are taking care of patients, so having access to the latest research that impacts how we take our patients is important. What Doctorpedia is looking at is: how do we gather all of that information on healthcare, which is very broad – it could be related to healthcare conditions like diabetes or depression – as well as the technology that’s out there that impacts health. Technology is moving at such a rapid pace that we cannot keep up with it as best we can, just going from website to website. It’s much more efficient and effective to make sure that we have the brightest minds and talent to be able to actually look at all that’s coming out in healthcare and processing it and putting it in a format that’s easiest for everyone to understand. Doctorpedia has taken that stance that – in video format particularly – we can all understand somewhat easier how we take a complicated issue such as healthcare. If we see it in video format, particularly, it’s much easier to digest and comprehend, as opposed to reading thick text that goes on and on. Doctorpedia has already done, I think, a fabulous job of understanding some of the technology out there, including apps. But there’s clearly a lot more in terms of wearables and different types of tools, utilizing artificial intelligence and machine learning. So breaking that down a little bit in ways that the average person can understand I think is remarkably helpful. Having a forum where patients, doctors, organizations alike can come and actually share that information is important. We do believe that we want to democratize that information across the world and not have it in the hands of a select few.
Daniel Lobell: (30:48)
Absolutely. Yeah, I was just agreeing with you and I hope that this podcast does its part in furthering that goal. I know that you’re no stranger to teaching as well, that you teach at Harvard and you’re surrounded by a lot of very accomplished bright people there. Can you talk a little bit about how that came about and what you get out of it?
Dr. Pracha Eamranond: (31:18)
Yeah. So I’ve been teaching at Harvard now for 15 years. I love the place. I went there for a reason. I feel as though I’m at one of the centers of learning – and I do believe that there’s a lot of amazing places out there to learn – and I’ve learned so much about medicine, about people from different places. There’s such amazing knowledge and clinical acumen in other parts of the world, you know, where I’ve practiced like India and Cuba and certain places in Africa, as well. But yeah, I think Harvard is a very special place. I have been able to learn so much from the students there as well as my colleagues and it continues to be a center of excellence where innovation can happen in addition to its collaboration with other universities, like MIT. I believe that it puts me in a place where I can have easy access to some of the things that are happening in healthcare. We are utilizing artificial intelligence to be able to manage how we look at certain treatments and allocate them to patients who can best benefit from newer medications and technologies.
Daniel Lobell: (33:04)
Is that something that we don’t see much of right now? Because in a way that’s a little scary to me to know as a patient that there are great treatments out there, but they’re not able to match up the treatment with the patient when needed.
Dr. Pracha Eamranond: (33:19)
Right. So I frequently have colleagues around the world who ask me about new cancer treatments, for example. We at Brigham Women’s Hospital (where I work) we work hand in hand with Dana Farber, which is one of the best cancer centers in the world. And so you have a lot of randomized trials looking at new medications. You’ve got a huge pharmaceutical industry here, too, where we’re looking to see what new types of medications are out there. You pair that with, for example, artificial intelligence where it can pull in all sorts of data from different places – even for example, a routine mammogram. Sometimes as physicians, we’ve spent our entire lives looking at mammograms, but a machine can look at millions of images and can see what’s truly a cancer and what’s truly not much better in some cases than the naked eye. Pairing all of these treatments and technologies will be able to better prepare us to take care of sick patients in a whole variety of clinical conditions. Cancer is just one of them that lends itself to technology enabling us to find the right treatments by looking at the specific patients and their genes and figuring out which treatments would be better for them that might not be good for everyone.
Daniel Lobell: (34:58)
Fascinating. Really, really interesting stuff. The information is out there and it’s only a matter of time before everybody gets on the same page.
Dr. Pracha Eamranond: (35:11)
Yeah. I mean, we would love for that to happen. It’s tough to say we’ll be on the same page. Even before the advent of emails, we were doing research studies that frequently took over a decade to get out to a patient. You might do a research study and publish it in a prominent journal. But by the time it actually gets widely adopted and we’ve determined its safety and its effectiveness, it could take many, many years before that happens. This is not too dissimilar where you might have a technology, for example, that looks at eye disease. A machine might be better at looking within an eye than the naked eye of a person, if it’s given the right information and if it has the right algorithms. But that process also takes years before we put it out into the mainstream. That’s why I feel as though as things come out, it’s nice to see a place like Doctorpedia where it can inform the general public about a lot of new technologies that are coming out that impact healthcare. The sooner we get everyone on the same page, I think the better it will be for the health and clinical outcomes for folks around the world.
Daniel Lobell: (36:33)
And so many lives will be saved.
Dr. Pracha Eamranond: (36:35)
Right. But there are many ways to do that. Clearly, there are a lot of websites out there. There’s a lot of companies that are focused on this work. We certainly want to contribute to what other leaders in the field are doing and work together to see how we can best democratize medical information and progress so that we can better improve the health of the population.
Daniel Lobell: (37:02)
And that brings me back to COVID-19. I almost wonder if somebody has already published in journal that has the answer–
Dr. Pracha Eamranond: (37:11)
Right! You can go online and see a lot of different publications on COVID-19. There’s a lot of news outlets that are covering the latest news, but there’s still a lot of work to be done in terms of how do we manage all of this? As an example, we have a neighborhood group that has formed together and we meet virtually so that we can share best practices, support each other from a social perspective and also protect each other. So there’s a lot of worth in trying to share information amongst each other. Clearly there’s no single platform that does that but we do expect that we’re going to be one of those platforms that really cracks the nut in getting that information out there to folks who need it.
Daniel Lobell: (38:12)
Let’s hope so. One thing that I didn’t get to cover with you that I thought was pretty funny and interesting from your blog was how you got into medicine. You mentioned in this blog that I read of yours that your parents discouraged you from going into medicine and that’s possibly why you went into it. So is that the answer? If you want your kid be a doctor, you tell them not to be?
Dr. Pracha Eamranond: (38:38)
[Laughs] Yeah. Well that’s kind of interesting. I always wonder myself whether I want my children to go into medicine, but my parents – particularly my mother – was very clear that I would be crazy if I went into medicine. It would be essentially shackling myself to a lifetime of hard work and she was right, actually!
Daniel Lobell: (39:04)
Dr. Pracha Eamranond: (39:07)
I remember putting in 100-hour work weeks and at one point telling myself, telling my wife that I can’t take this anymore. I mean, this is just demoralizing to go through medicine, taking care of patients when you’re so exhausted after a 36 hour shift. Luckily, things have improved since then. But now in hindsight, I don’t regret the choice I made. I think my parents still believe that I might be a happier person – even though I’m very happy – I might be even happier if I didn’t go into medicine because they’ve seen how hard I’ve worked in various stages of my career.
Daniel Lobell: (39:52)
Well we, the patients, appreciate it. I’ll tell you that much.
Dr. Pracha Eamranond: (39:55)
Thanks, Danny. I appreciate that.
Daniel Lobell: (39:57)
I ask all the doctors to round off the interview with this same question and I know we talked a little bit about tango, but what else aside from tango do you do to stay healthy?
Dr. Pracha Eamranond: (40:07)
So I would say several things. One thing I try to do every morning is meditate and that automatically resets my mind so that I have more clarity throughout the day and settles a lot of the emotions that I go through. And I don’t pretend that I’m the calmest person on the planet, but certainly given the level of stress that I undergo as a physician, as a teacher, as a parent, as a husband – meditation helps me manage a lot of the issues that do cause me stress. Above and beyond that, there are other things that I do in terms of trying to stay healthy and be well. I do think, as we discussed, tango is a meditative state between two people and there’s clearly health benefits to dancing with other people. But it doesn’t have to be. I bike regularly, which I really enjoy. There are many forms of meditative activities, whether it’s walking or hiking or a number of things. I’ve spent a lot of my life doing martial arts. Tai Chi is another one that I think is a great activity for folks that don’t necessarily want to meditate. I think if you are inquisitive and want to help yourself, you will find an activity that will lend itself to your own personal wellness. I think there’s also a lot of literature to say that we should be teaching meditation to our children, to our friends, to our students because we can more effectively help others if we are well ourselves. That probably is a long discussion and another podcast.
Daniel Lobell: (42:39)
Dr. Pracha Eamranond: (42:39)
I think there’s lot of things that we can do to keep ourselves healthy. Particularly during the COVID outbreak, when we’re essentially forced to spend a lot of time thinking about ourselves and what we’re doing within our own homes and within our own communities, whether it’s Tai Chi or biking or walking, meditation, dance (certainly for me at home with my wife) – these are all forms of helping me stay sane and healthy. I’m very appreciative that I have access to that despite not being able to travel or do all of the other things that we’re normally doing throughout the day.
Daniel Lobell: (43:29)
Yeah, well, it’s sound advice and I think everybody at home should implement that even if it’s dancing by yourself.
Dr. Pracha Eamranond: (43:36)
Daniel Lobell: (43:36)
Dick van Dyke wrote a book called Never Stop Moving and he talked about he’s in his nineties and he dances every morning – puts on some music in his kitchen and dances to stay healthy.
Dr. Pracha Eamranond: (43:49)
Yeah, that’s awesome.
Daniel Lobell: (43:50)
I think it’s inspiring. So keep dancing, keep moving, and thank you very much for all the great work you’re doing here at Doctorpedia and out there as a doctor in the world right now.
Dr. Pracha Eamranond: (44:03)
Thanks Danny. I appreciate it.
Daniel Lobell: (44:21)
This podcast or any written material derived from its transcripts represents the opinions of the medical professional being interviewed. The content here is for informational purposes only and should not be taken as medical advice. Since every person is unique, please consult your healthcare professional for any personal or specific needs.