When Doctors Play This Game, You Get Better Medical Care

Enlarge this image toggle caption Lisa F. Young/iStockphoto Lisa F. Young/iStockphoto

Doctors are required to keep current on best medical practices, but those efforts all too often don't do a thing to improve patient care. But what if the class is a game — one that lets you compete against other doctors and show off your smarts?

Plus you get funny emails. Oh, and your patients get better, too.

Enlarge this image toggle caption Courtesy of the Veterans Affairs Boston Healthcare System in Boston Courtesy of the Veterans Affairs Boston Healthcare System in Boston

That's the gist of an online game tested at eight Boston-area hospitals to see if it could improve treatment of high blood pressure by getting practitioners to follow recommended treatment guidelines.

Patients of the doctors and nurses who played the game over the course of a year got their blood pressure under control faster than those whose primary care providers were told to read educational materials instead, a "modest but significant" improvement, the researchers say. The results were published Tuesday in the journal Circulation.

How did they do it? By combining bad stock photos like the geezer gamers above, silly captions and multiple-choice questions on medication protocols. Hard to imagine, I know. So take a gander at the "ebullient 37-year-old man with a fear of chest-waxing" at left, typical of the kind of question players got by email.

That got my attention. So did an even stranger stock photo that the researchers labeled "the 43-year-old captain of the Norwegian synchronized swimming team." When I opened that email, I laughed out loud.

That's the goal, says Dr. B. Price Kerfoot, a surgeon at the VA Boston Healthcare System and an instigator of the game. He and his compadres spent late nights on iStock, gleaning photos that would get people to keep opening the game's emails. "You don't have to give root canals to get people to do it," Kerfoot tells Shots. "We hear all the time that people look forward to the next question."

Enlarge this image toggle caption Johann Frank/iStockphoto Johann Frank/iStockphoto

He pauses. "I hope we don't offend too many Norwegians."

Beneath all the silliness is a tested theory of learning called spaced education. Complex information is doled out in little bits, then repeated. Get a question right a few times, and you move on to a new one.

The repetition helps people remember, but only if they stick with the program. And it turns out that the biggest motivator, even more than the funny photos, is the element of competition. (Evidently doctors like getting straight A's even if it's been years since med school.) Letting players compete was an afterthought added by a programmer, Kerfoot says. But it's proved wildly popular.

Indeed, the hospital where Kerfoot works has a leaderboard listing game scores. Players use aliases (classic rock bands are popular), but everybody knows who's on top.

Indeed, competition has proved even better at motivating people than handing out prizes like fleece jackets or small monetary rewards, which Kerfoot has tried in other studies. Having people compete in teams helps, too.

Up next: a study that will let patients compete to see who's best at diabetes management. "We have high hopes that this will be effective for them," Kerfoot says.

You can try the VA hyptertension game yourself at Qstream, a company Harvard created to sell the spaced education concept to hospitals and medical practices. Are you smarter than a doctor?