Dr. Brian Alper Relishes the Ability to Give Back
Brian Scott Alper, M.D., M.S.P.H., HU ’96, has returned to his childhood home in Northeast Philadelphia. Based in Ipswich, Mass., he is here to visit his parents, Sandy and Al Alper.
Not yet 40, Brian has taken an idea he originated in medical school some 18 years ago and developed it into a thriving initiative called DynaMed, a medical reference database. The success of this venture has brought the luxury of giving back, and he recently made a sizable gift to the general scholarship fund of Drexel University College of Medicine. But through his ongoing work on DynaMed, he gives back to the College of Medicine and the medical field every day.
“Let’s go back to ’92, ’93,” Brian says. “I was in medical school, and I realized that you can’t memorize medicine. When you go on clinical rounds, you might be asked to name 15 causes of an illness, and you can’t just memorize all of that for every illness, but you need that information. My interest in medicine was about taking care of people, so in my second year of medical school, I organized information in a way that I could find it when I needed it. For me, this was an electronic reference system, and at the time, it was in Word Perfect. I had about 2,000 documents. I used a standard template and had a document for each disease. Back then, you could have only eight letters in a document name so there was another document just to look up titles. That was the first form of the database that is now called DynaMed.”
When seeing patients in clinical rotations in his third year of medical school, Brian found his database even more useful than MEDLINE (the bibliographic database of the National Library of Medicine) or textbooks. In his fourth year, Brian wanted to do his clinical rotations in rural medicine, but Hahnemann didn’t offer that option, so he elected to do rotations at East Tennessee State University. “I didn’t have a laptop,” he says, “so I put the computer in the car and took it with me to Tennessee. I spent a month in a town called New Tazewell. This was a chance to see what the real world was like, and I could see my database not just making a difference for me, but also for other physicians and physician assistants. They would ask, ‘What do you have on this?’ and it often would change their diagnosis and treatment. That was a life-changing experience for me. I saw that a reference like this was something that was needed.”
He received the same feedback from the faculty at Hahnemann, who encouraged him to develop it further into a more formal database. “My father already was using Lotus Notes in his business,” Brian says. (Al is a roofing contractor.) “Lotus Notes had replication properties so you could keep the information up-to-date and replace only the information that had to change. We knew if you had to update your system by getting disks in the mail, that wouldn’t work. This was before I knew enough about the internet, so the two of us created the first formal database using Lotus Notes. We named it Dynamic Medical Information System, and the mission was to provide the most useful information to the health care professional at the point of care.”
In 1996 Brian and Al developed an internet presence and contacted specialists who would provide feedback via email. This was the first form of peer review for DynaMed. “Some of those reviewers still contribute to DynaMed today,” Brian says. “We have reviewers from Drexel University College of Medicine, and students have access to the site, as well.”
After graduation, Brian completed residency in family medicine at Penn State University/Good Samaritan Hospital in Lebanon, PA and then moved to Columbia, MO, for a fellowship (and then teaching and practice as faculty) at University of Missouri-Columbia, and continued developing DynaMed. He developed DynaMed further as a small business with substantial support from his wife Karen, father Al, and many others.
Then about five years ago, he affiliated with EBSCO Publishing in Ipswich, MA. EBSCO Industries has been in the information business for more than 60 years. EBSCO Publishing is a division that is the world leader in providing research databases across disciplines.
EBSCOhost serves thousands of libraries and other institutions with premium content in every subject area. Brian connected with the company by networking with librarians at nationwide conferences, and now, along with a dedicated editorial staff of more than 40, works together to achieve DynaMed’s founding mission to provide the most useful information to the health care professional at the point of care.
Individuals, academic institutions, hospitals, and other organizations can purchase subscriptions to DynaMed, and qualified reviewers can sign up to contribute at the site, ebscohost.com/dynamed. “We’re in more than 170 countries, and 60 to 70 percent of the medical schools in the U.S. subscribe,” Brian says. “We have reached every continent, including many remote settings on hand-held devices where the internet is not reliable.”
Today DynaMedprovides clinically organized summaries for more than 3,000 disease topics including diseases, conditions, symptoms, drugs, and differential diagnosis. DynaMed strictly adheres to a seven-step system for content that includes identifying the evidence, selecting the best evidence from that identified, evaluating the selected evidence through critical appraisal, objectively reporting the relevant findings and quality of the evidence, synthesizing multiple evidence reports, deriving overall conclusions and recommendations from the evidence synthesis, and changing the conclusions when new evidence alters the previously best available evidence.
Looking back at the beginnings of Brian’s medical education, Sandy joins the conversation: “Brian was able to get [Hahnemann’s] interest while he was a high-school senior,” she says. “He took [Advanced Placement] classes in biology and chemistry, and he took an AP class in organic chemistry at night at Temple so he could qualify.”
Al adds, “Brian took the [Medical College Admission Test], and he could have gone straight to medical school from high school, but then he received a Braddock Scholarship [for full room, board, and tuition for four years] from Penn State, so he decided to go there first, and after he graduated from there, he had a full scholarship at Hahnemann.”
Brian notes that throughout his residency and fellowship, he lacked the financial resources for philanthropy other than small contributions here and there. But after years of planning, dedication, and hard work, he says with obvious satisfaction, “Now I can start doing some charitable giving in a meaningful way.”