don't know it all
Bud Rose '63 helps them find answers
In the mid '80s, Burton "Bud" Rose '63 came across a
study that found that two out of three patients raised a question
during an office visit to which their doctors did not know the answer.
And if a doctor could answer all her patients' questions, she would
change four treatment decisions in every half day of practice. That
study motivated Rose, a nephrologist, to develop an informational
resource for physicians that answers their questions in just minutes
A clinical professor at Harvard Medical School, Rose started UpToDate
in his basement in 1989. He compiled information on his own specialty
first, then added cardiology, oncology, infectious diseases, and
obstetrics and gynecology, among others. More are being added.
UpToDate's database, which is available online (uptodate.com)
and on CD, is organized by the questions doctors might have on how
to treat a patient, such as how to manage an asthmatic during pregnancy.
Rose and his staff "recruit experts from around the world to
write answers to those questions," he says. The answers include
a summary of the published literature and recommendations on the
action to take.
Individual health care providers and major teaching hospitals,
including Duke, Johns Hopkins, and Harvard hospitals subscribe to
the program. Doctors can use it for a quick answer or to review
current literature. "What UpToDate allows any doctor to do
is achieve instant expertise in any area," says Rose. His company's
mission "carries with it a giant responsibility ... to be right."
So it has all kinds of quality controls, says Rose.
A doctor emailed Rose a few months ago to say that UpToDate helped
him save a life: "A patient came in with abdominal pain,"
says Rose, " and blood in the urine. The first thought was
that the patient had a kidney stone. But the doctor taking care
of the patient just wasn't comfortable. Something didn't seem quite
right." So she checked UpToDate and found that one of the diseases
that can mimic a kidney stone is an aneurysm of the aorta. That
diagnosis of a potentially fatal condition turned
out to be correct.
By Kathryn Federici Greenwood
You can reach Kathryn at firstname.lastname@example.org