Maxine Papadakis, M.D. is Attending Physician at the San Francisco VA Medical Center, and Professor Emeritus of Medicine and formerly Associate Dean for Students at the UCSF School of Medicine. A general internist by training, Dr. Papadakis has been one of the primary editors of Current Medical Diagnosis and Treatment (CMDT) since 1992. Her role on CMDT, alongside Stephen McPhee, MD and Michael Rabow, MD is to set the content for each annual edition of CMDT, to select contributors, and to edit all chapters into the practical, authoritative format readers around the globe have come to rely on for more than 50 years.
AccessMedicine: Can you tell us how you first became associated with Current Medical Diagnosis and Treatment (CMDT), and when you become one of the editors?
Dr. Papadakis: Steve McPhee was my chief resident at Johns Hopkins when I was a resident and Larry Tierney was my fellowship advisor at UCSF. These two individuals were editors of CMDT when I came to UCSF. It was my great luck that they brought me on board as an editor in 1992 when another editor was rotating off. I will always be grateful to Steve and to Larry for giving me this opportunity.
AccessMedicine: What are the pluses and minuses of the annual publishing schedule?
Dr. Papadakis: The pluses are that CMDT is certainly current, often more current than review articles that are published in major journals. Learners can purchase the latest CMDT at the beginning of the academic year. The annual schedule for CMDT provides structure to the authors who know when and what to expect and can plan in advance (at least most of them!). The editors and staff have the built-in structure as well.
The minuses are mainly the time crunch of an annual publication, which is more acute for the print version than the online version.
AccessMedicine: CMDT 2019 just launched on AccessMedicine. There is a more synoptic quick reference version available as well on AccessMedicine. Can you talk about how and when you use Quick Medical Diagnosis and Treatment (QMDT), compared to how and when you use CMDT?
Dr. Papadakis: I use QMDT when I’m seeing patients and I have a focused clinical question which needs a quick clinical answer. CMDT provides a more thorough discussion.
AccessMedicine: CMDT resonates across so many health professions, from medical education and practice to Physician Assistants (PA) to advanced practice nurses (APN). Why do you think this is, and as an editor of CMDT how do you continue to ensure that the content appeals to these different audiences?
Dr. Papadakis: Clinicians today obtain much more information on the spot. They are not expected to know everything. Rather, they have refined their problem solving skills to include continuous assimilation of new data and to use expertly developed clinical guidelines. CMDT provides information AND recommendations from the experts. The combination of fact and judgment gives the reader a prioritized approach to patient care. CMDT also provides the right amount of pathophysiology to contextualize the clinical issues. The constant editing for clarity provides a resource that is approachable by audiences from all disciplines.
AccessMedicine: Tell us about practicing medicine in 2018—the highs and lows, the ups and downs?
- The patients, first and foremost, and the opportunity to serve them
- Incredible advances in science and its translation to medical care
- Exhilarating interventions to improve health for the individual and for populations
- Clinical outcome studies that inform evidence-based care, an advance over reliance solely on the opinion of experts.
- The ability of the electronic medical record to quickly retrieve patient information
- Access to care is not universal
- Growing intrusion into the time for patient care and for teaching by administrative, compliance, and billing issues
- We still need better therapies and preventions for many of the illnesses that we treat
- Unmet expectations of patients and families
- EMRs are not user-friendly for the providers
- Reimbursement issues, especially those that do not reward time spent with patients
AccessMedicine: As you look at younger students just coming into medicine today, how are they different than previous generations? What are their information use habits, and what they looking for in information resources?
Dr. Papadakis: Students entering medicine today have the same commitment, work ethic and professionalism as in the past, and maybe even more so.
A difference from the past is that these students have access to instantaneous information. The challenge is to know what information to use and how to use it. CMDT is written by respected experts who answer that challenge. CMDT answers the question of what information resources to use, both by what is written in the text and the accompanying references, which are key to navigating the available resources. CMDT is one-stop shopping.