The video, “Kidney Transplant – A Better Option for Dialysis Patients,” offers a lively, animated take on a serious subject and is available on YouTube in English, Spanish and Creole. Although intended for the South Florida patient population, the video was created in the hopes that transplant centers elsewhere might find it useful in educating prospective kidney transplant patients in their area.
“In 2010, when I was a first-year medical student, I began a research project that explored why so few patients — specifically minorities — with kidney failure end up getting a kidney transplant,” said Shivam Joshi, M.D., now a third-year medical resident at Jackson Memorial Hospital. “Research abounds on the topic, but we went ahead anyway — mostly to flesh out details on minority care and to have solid proof that the problem exists in our own back yard.”
In fact, that is exactly what they found. Their analysis of 1,910 patients waitlisted at the Miami Transplant Institute (MTI), a joint venture between the Miller School and Jackson, revealed the longest wait times and poorest outcomes for black patients and the best for white patients, with Hispanic patients falling in the middle. The researchers largely attributed the disparities to differences in socioeconomic and citizenship status. However, the differences for blacks could not be completely explained. Their findings were published in the journal Transplantation, with Joshi as first author, in 2013.
Joshi said the authors thought about ending their article with the familiar refrain about the need for more research — but they didn’t. Instead, they determined that an intervention was needed — a more extensive patient-education campaign — and the idea for the video was born.
“Our findings only added to an already sizable body of knowledge about a known problem; doing more research wasn’t going to solve it,” Joshi said. “Only a few patients were being transplanted before starting dialysis, when avoiding dialysis altogether is best. And a large number of patients — specifically minorities — were spending months, even years, on dialysis, when the time spent on dialysis before a transplant should be kept as short as possible. ”
Joshi raised $10,000 from Novartis and $5,000 from Jackson to fund the project, and recruited two fourth-year Miller School students, Wei Yang and Hadi Kaakour, who had video production experience, to assist him. Initially, he intended the video to consist of interviews with patients, but Yang and Kaakour suggested animation. There were a lot of people videos out there already, they told him, and most of them were “boring.”
“I let them take ownership, and it turned out to be a great decision,” said Joshi. “Everyone who has seen the videos has said they stand out because they are different. We hope they will be an inspiration to others to effect practical change in other areas of medicine that so urgently need physician leadership and action. Sometimes, instead of turning research into more research, the best course may be turning your findings into actionable change — even if you are only a medical student.”
Joshi wishes to acknowledge his gratitude for additional important contributions to the project from Gaetano Ciancio, M.D., M.B.A., professor of surgery and urology, Associate Director of Kidney and Pancreas Transplantation, and Director of Urologic Transplant Surgery, Alayn Govea, M.D., a former Miller School student, now a resident at University of California, San Francisco, Giselle Guerra, M.D., assistant professor of clinical medicine and Director of the Living Kidney Donor Program, Warren L. Kupin, M.D., professor of clinical medicine, and Oliver Lenz, M.D., professor of clinical medicine and Medical Director of Jackson Memorial Hospital Nephrology Clinics.
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