Wednesday, July 13, 2016

The American Medical Association to Lobby for Gun Violence Research

In the United States, federal funding cannot be used by the Center for Disease Control to study gun violence.  Though the American Medical Association (AMA) has attempted to direct funding for such research in the past, Congress has prevented them from gaining access to this money.  The research proposed would enable physicians to better treat gun injuries and help public health officials understand what measures are necessary to reduce gun violence.  Opponents from the NRA argue that gun control is a political matter and that physicians should have no say in this issue.  Ultimately, I think it will be politicians who craft gun laws, but physicians may be able to further understand the medical effects caused by gun violence, and which people are more likely to use guns inappropriately.  Also, public health employees are more qualified to discuss the effects of gun control with politicians.  Are there other groups more adept to conduct such research?  Another article lists that Johns Hopkins has a center for gun research, so perhaps the funding could be allocated to groups like this one.  Available data suggests that background checks prevent criminals from obtaining guns, and that certain types of gun storage may prevent shootings, presumably because the potential shooter would fail to access the gun.  Data from other countries shows that three European countries have more mass shootings per capita than in the United States, but other advanced civilizations do not.  Perhaps the United States can learn from gun violence research in other countries until the funding is granted.  Feel free to comment.

http://www.usnews.com/news/articles/2016-06-14/ama-calls-gun-violence-a-public-health-crisis, http://www.theatlantic.com/politics/archive/2016/01/gun-control-laws-research/424956/, http://www.politifact.com/truth-o-meter/statements/2015/jun/22/barack-obama/barack-obama-correct-mass-killings-dont-happen-oth/

Sunday, May 29, 2016

States Focus on Adding Residencies for Physicians to Remain

It is known that 68% of physician who complete their residency in a certain state will remain after completion of their training.  Unfortunately, some states do not have an adequate number of residency programs.  I think the federal government could reallocate the Medicare funding for residencies to favor the growth of such programs in certain states.  For example, Mississippi and Tennessee train more physicians than they have residency programs.  With federal, along with state support, the physician shortage could be somewhat alleviated by relocating physician training sites, rather than focusing on the production of more medical schools.  This is particularly problematic for states like Florida, that has created five new medical schools since funding for residencies was capped in 1997.  Also, since funding is limited, the cap would have to be raised to receive any federal help, and until then, the burden for funding is left to individual states and hospitals.  Are there any other ways to alleviate the physician shortage?  Could physicians who graduated from approved residencies in foreign countries be allowed to practice here?  It would not only alleviate the shortage, but project the cost of physician training to other countries.  Feel free to comment with more suggestions.

From: http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2015/08/11/to-address-doctor-shortages-some-states-focus-on-residencies

Tuesday, April 12, 2016

Doctors Often Make More Money Prescribing More Expensive Drugs

Currently, physicians have an incentive to use the most expensive drugs possible, as they are reimbursed by Medicare in proportion to the price of the drug.  However, this may not be the best for patients' health, as less expensive drugs might work better.  A new experimental program will reimburse physicians at a flat rate.  Therefore, under this philosophy, physicians would no longer have an interest in prescribing more expensive drugs unless they believe that the patient would benefit more.  Some groups oppose this, saying that health outcomes in cancer patients improved while spending rose, and that Medicare reimbursement is already low, making certain treatments more difficult to perform.
I agree that such critics have a point.  Many physicians probably prescribe expensive drugs based on their physiological results, but there could be others who prescribe them for more financially related reasons.  I think a potential solution to this is to keep the current reimbursement system and not prescribe expensive medications unless the patient meets certain qualifications.  Therefore, only the sickest patients receive more potent drugs.  This does not necessarily mean, though, that the most expensive drugs are more potent.  Are there any other ways to solve this problem?  Feel free to comment.

From: http://www.kspr.com/news/health/medicare-change-perverse-incentive-or-perverse-reform/21051714_38973830

Monday, March 21, 2016

What Makes Medicine Worthwhile

I think the below article makes an important statement that would put a smile on many doctors' faces.  The author proclaims that she has considered leaving medicine on numerous occasions for unspecified reasons, but continues to practice to fulfill her desire to care for patients.  In reality, many activities of being a doctor involve spending time outside of patient contact, including diagnosis, prescribing, and discharge.  But, the author notes, one study done by Harvard University concluded that relationships with other people was a key to a happier life.  Indeed, the author believes that the time she does spend with patients is an "immense privilege," an opportunity to fix even the smallest details of a person's life.
I agree with this line of thought.  People's satisfaction with their lives largely depends upon their actions, thoughts, and feelings, all of which make up one's health.  Doctors are fortunate to have the opportunity to readjust each of these aspects, if need be, to improve the health of one's life.  Ultimately, this is what makes the world a more satisfying place for all.  I plan that this professional endeavor will keep me involved in medicine despite the many difficulties of being a doctor.

From: http://www.theguardian.com/healthcare-network/views-from-the-nhs-frontline/2016/mar/21/junior-doctors-strikes-nhs-leaving-medicine-people-make-me-stay

Thursday, February 25, 2016

How Necessary Is Pain Management?

Pain management may consist of a variety of specialties, including anesthesiology, neurology, psychiatry, and physical medicine and rehabilitation.  Recently, especially due to increases in the recreational use of opiates, many physicians are becoming more hesitant to prescribe narcotics.  However, chronic pain is a problem for an estimated 100 million Americans.  Clearly, there is a need for such treatment.  The question is how should this treatment be performed. 
Some of the best pain clinics probably include specialists from all the above mentioned disciplines.  In this way, a patient's pain treatment could be tailored to their individual situation.  For example, someone who had experienced psychological trauma might benefit more from the psychiatrist, whereas someone who has back pain after surgery would need intervention from an anesthesiologist.  Eventually, the physician would have to cut back the medication to prevent addiction.  According to the article, one physician says he "uses a multidisciplinary approach that could include surgery, yoga therapy and Pilates," which works 90% of the time to wean patients off of their medication. 
Unfortunately, chronic pain is rarely entirely relieved, and so patients should not expect perfect results from their treatment.  It is also important to note that consultations, which may be greatly beneficial, are not always covered by insurance.  This is especially difficult for neurologists, who can spend hours at a time talking to individual patients.  Insurers might see better results and ultimately save money if they reimburse for more holistic approaches to pain relief instead of merely procedural interventions.  
Is it possible to convince insurers to do this, however?  What happens to patients who become addicted?  Will they seek narcotics from other sources if pain management physicians drop them?  And are other specialists successful in weaning patients off their medication if the problem is truly chronic?  Feel free to comment!

From: 
https://www.angieslist.com/articles/few-gains-chronic-pain-treatment.htm

Sunday, December 27, 2015

Aging Parents Continue Caregiving for their Children with Disabilities

I find this topic incredibly important as it becomes more prevalent in our society.  In the past, children with severe disabilities may not have survived longer than their parents.  Today, however, this is more possible with recent developments in medication.  Still, we usually think of children providing for their elderly parents, but what happens when the opposite must occur?  If the parents die, where do the children with disabilities look for further care?  And do many caregivers continue to care for these children even if they are unable to do so?  According to the article, some agencies are now bringing together those who work with the elderly and those who work with the disabled.  I hope these groups will devote funding and caregivers trained to handle these types of situations. 


From:  http://www.jewishjournal.com/opinion/article/aging_parents_of_disabled_adult_children_are_feeling_the_strain

Monday, November 30, 2015

Could Specialists Act As Primary Care Doctors?

 My opinion:  I've frequently thought about this issue myself, but I wasn't sure if this were even possible.  Specialists, like cardiologists and gastroenterologists, went through an internal medicine residency (which is primary care) before they did fellowships in their desired subspecialties.  The article discusses a new program where retired specialists could be re-trained to perform primary care.  I think this is a great idea, especially since many of these doctors could use a refresher on how primary care is practiced today.  I don't know if many retired doctors would be willing to do this, however, but it does appear that they often retire late, or continue to work part-time well into their 70s or later.  Another problem is licensing these physicians, as many of them may not want to take long board exams.  Perhaps boards could become more lenient for primary care physicians, since they do not need as much expertise in specialty disciplines.  This could also encourage more people to pursue primary care in general.  s this idea as realistic as it sounds?  Feel free to comment.
 

From: http://www.wsj.com/articles/second-acts-a-retired-surgeon-takes-on-a-new-medical-mission-1448852623