THE INTERVIEW: Dr Val Jones, Canadian student turned American MD, blogger and cartoonist

Educated in Nova Scotia before she moved to the United States to do degrees in biblical studies and medicine, Dr Val Jones is now one of the most popular physician bloggers. Her work has appeared in MedPage Today, Revolution Health, a now-defunct blog called Dr. Val and The Voice of Reason and, most recently, her own internet company Better Health.

Last year, Dr Jones was accredited as a member of the National Press Club in Washington, DC, and has focused much of her recent reporting on health policy reform efforts. She still practises medicine part-time as a rehab specialist at Walter Reed Army Medical Center. Dr Jones is also a talented cartoonist and her cartoons' take on medicine displays a sharp, wry sense of humour.

This week, Dr Val agreed to answer some questions for Canadian Medicine:

Canadian Medicine: Did you know as an undergrad at Dalhousie University, in Halifax, Nova Scotia, that you wanted to be a physician?

Dr Val Jones: Dr. John Schullinger, a pediatric surgeon at Columbia University College of Physicians and Surgeons, saved my life as a baby, and he kept in touch with my mom via Christmas cards every year. I grew up admiring him greatly and wanting to "give back" and maybe save other babies as a way to thank him. I got side tracked here and there, but eventually ended up in medical school at Columbia with him as my mentor. It was very touching for me, though I feel a little guilty that I didn't become a pediatric surgeon.

What inspired you to move from Nova Scotia to Texas?

I had a spiritual awakening in college, and became a Christian. I went to Texas to get a Masters' degree in Biblical Studies in an effort to learn more about the history of my newfound faith. I worked as a youth minister in Texas for a short time, and then went on to do research at the Mayo Clinic before medical school. I'm a bit unusual in that I'm fully committed to science-based medicine and also maintain moderate religious views.

You’ve been among the most popular medical bloggers for the past few years. What do you attribute that to?

Endurance. I'd like to say it's because I've got "mad skills" but honestly, it's probably more related to the fact that I have the stamina to write something original every day for years on end. I'm also a social creature, so I enjoy leaving comments on other peoples' blogs and participating in social media on a regular basis.

Do you still practise medicine? Do your patients ever mention things you’ve written?

I volunteer as a rehab physician at Walter Reed Army Medical Center about once a week. Unfortunately, I haven't yet met a soldier who's read my blog. However, the Deputy Director of Communications for the National Museum of Health and Medicine (on the Walter Reed campus) found me on Twitter and gave me a guided tour of the museum. That was a real treat. I blogged about it here.

Any advice for doctors who are interested in getting into writing and/or blogging?

Just try it and see if you like it. Blogger is free, or you can create your own website at very little cost. And if you find that you enjoy it and want to do it regularly, you can join a network like Better Health to enhance your traffic and amplify your voice.

In addition to your writing career, you’re also draw medicine-themed cartoons. How did you get into that?

When I was working at Medscape one of the editors complained about the lack of good medical cartoons. I'm a problem-solving kind of person so I figured I'd try my hand at cartooning (I always liked to draw). I came up with the cartoon series idea and it became a big hit -- I've even had my work featured at medical conferences and at the National Press Club. I wish I had time to do more of it.

You started a company and blogging website called Better Health last year, which has seen you following healthcare reform political events in Washington quite closely. What’s your best guess on where the healthcare in the US is headed?

It's headed towards rationing. There's just no way around it. Everyone is going to have to tighten their belts, and figure out how to do more with less. That doesn't sit well with the American psyche.

Would you like to see the US adopt a Canadian-style single-payer system?

Actually, I wouldn't. I think we're going to have to find a "uniquely American" solution. I'd be happy to have primary care delivered by low cost, cash-based medical practices (like Doctokr Family Medicine), make sure everyone has at least a high deductible sickness insurance plan, and have the government subsidize care for the very ill or very poor. Employers can also incentivize healthy lifestyle choices -- this has been working well for Safeway and Caterpillar for example. The trick is to make sure that no one stakeholder has too much power - so the system doesn't exist to serve their priorities, but the needs of patients.

Is healthcare in Canada still demonized in the US to the extent it was in the 1990s? There was a touch of that just recently when opponents of universal healthcare shoehorned the death of actress Natasha Richardson into the public-vs.-private paradigm.

I haven't noticed any demonization. I think the perception is that the Canadian system isn't a great model - that there are long lines for care, that people are crossing the border when time is of the essence, and that the provincial governments (rather than physicians and patients) are determining how and when care is provided. I don't know if most Canadians would agree with that description. But one thing I can tell you -- the US should definitely look to Canada for legal reform. In a recent interview with Senator Michael Kirby, I learned that frivolous lawsuits are charged to the plaintiff's account, that judges set awards (not juries) and there are caps on payouts. If the US adopted that approach to legal matters, I'm sure we'd save billions a year... which, if we were smart, we could invest in getting more people access to affordable, quality healthcare.

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