John Bedolla has dedicated his career to understanding how people make choices. An expert in diagnosing rare and unpredictable diseases, he develops evidence-based decision-making strategies — what he calls software for the brain — that doctors use to solve difficult problems.
“The most powerful tool in medicine is the clinician’s mind,” said Bedolla, assistant director of research education and assistant professor of emergency medicine at Dell Medical School. “New technologies, tests, and procedures — those might affect clinical outcomes 10 or 20 percent of the time. But if you can change a doctor’s cognitive approach to care, you can improve the outcomes of every patient they see.”
Together with his wife, Anna, Bedolla is making a $50,000 gift to Dell Medical School to develop the minds of future physicians through research experiences. The Bedolla Endowment for Emergency Medicine and Student Research will provide funding to medical students and residents working on projects in emergency medicine, game theory, cognitive science, or medical decision-making.
“When students conduct research, they become better readers of literature, which makes them better doctors,” Bedolla said. “By providing small amounts of resources to students year after year, our gift will have a broad impact and help to create a better healthcare system for our community.”
Bedolla’s former patient Jill Hall and her husband, Sterling Smith, also made a $50,000 gift to support student research in recognition of Bedolla’s outstanding commitment to patient care.
“When we first met Dr. Bedolla in a Seton emergency room, we knew that he was a very special doctor,” Hall said. “We hope that our gift will help Dr. Bedolla’s students gain knowledge and skills through research, while also developing their human side.”
These gifts qualify the Bedollas and Hall and Smith for membership in Dell Medical School’s Founders Circle, which recognizes contributions of at least $50,000 made before the first class graduates. Founders Circle members receive a number of benefits, including recognition in a permanent display in the school’s Health Learning Building.
Bedolla was drawn to the field of emergency medicine not only for its breadth and patient focus but also for its inherent challenges. He thrives on making choices with uncertainty and constrained resources.
“I see emergency medicine as a chess game, with the patient and physician on one side and the disease on the other,” he said. “And winning, on behalf of the patient, is all about making the best, most strategic moves.”
Whether teaching medical students, supervising residents, or mentoring fellow faculty and physicians, Bedolla is committed to helping doctors mount the best defenses possible against diseases.
His approach begins with developing a trusting relationship with the patient while conducting a thorough medical history and physical.
“There is something magical about the relationship between doctor and patient,” he said. “In cardiac surgery, for example, research has shown that patients who feel a positive connection with their doctor do measurably better than patients who don’t feel any.”
After extracting every piece of information possible from his interaction with the patient, Bedolla leverages his knowledge of likelihood ratios, demographics, and other statistics to make the best possible diagnosis — minimizing the need for costly tests.
Dell Medical School seeks to equip future physicians with the communication, leadership, and technical skills necessary to effectively use value-based, patient-centered care approaches like Bedolla’s. The school’s innovative undergraduate curriculum shapes medical students into active, lifelong learners who are adept at efficiently using resources to develop the most effective solutions to challenges.
“When doctors aren’t experienced with active learning, they default to a simple operational strategy — ordering tests,” Bedolla said. “The problem with medicine is not a lack of tools. It’s a lack of good, strategic use of those tools.”
Bedolla’s journey to becoming an emergency physician began on the Forty Acres as an undergraduate student in the Plan II Honors Program in the College of Liberal Arts. With a focus on active learning, the program’s self-directed curriculum allowed him to study subjects he found interesting, including philosophy, math, and science. After graduating in 1987, he attended medical school at the University of Texas Southwestern Medical School, where he encountered a different type of educational approach.
“Back then, the traditional medical school experience was very passive, which is not what I was used to,” he said. “But Plan II prepared me very well to be an effective resident and physician, and now a great faculty member and researcher at Dell Med, which I see as kind of the ‘Plan II’ of medical schools.”
Bedolla went on to train in surgery at Oregon Health and Science University in Portland and in emergency medicine at St. Luke’s-Roosevelt Hospital in New York City.
As a researcher, Bedolla has seemingly broad interests, including heat illness, cardiac arrests, urinary tract infections, cycling injuries, and motorcycle racing — to name a few. But all of his projects focus on one underlying idea: understanding how people make choices.
For example, what choices does a person make when about to crash a motorcycle?
In Grand Prix motorcycle racing, there are two types of crashes: a low side, which causes the bike to slide along the track, and a high side, which sends both the bike and rider flying through the air.
“When you make a high side, you have a one in seven chance of ending up with a concussion and being out for the rest of the race,” Bedolla said. “What we realized is that the decisions racers make instinctively to try to save the low sides often cause them to end up having a high side.”
Bedolla’s findings changed motorcyclists’ approach to professional racing. Today, standard practice is for racers to slide out when faced with a possible low side, which has markedly decreased the incidence of dangerous high sides.
In addition to his work with the Dell Medical School, Bedolla serves as director of risk management for U.S. Acute Care Solutions, the only physician-owned emergency medicine care provider in the country, with more than 1.2 million patient visits per year. He is the creator and director of SafetyCore, an evidence-based medical risk-reduction program, and a trackside rescue physician for F1 and motorcycle races at Circuit of the Americas. He is a fellow of the Texas Leadership and Advocacy Program of the Texas College of Emergency Physicians and a member of numerous professional societies, including the American College of Emergency Physicians, the Society for Medical Decision Making, the American Stroke Society, and the International Council of Motorsports Sciences.
Bedolla lives in Austin with his wife and their two children, Jack, 14, and Carmen, 9.
Published May 2018