Primary Care Shortage: USA Today reports about the looming shortage in primary care and family physicians facing the United States. Even as the baby boomer generation retires, more and more young doctors are choosing lucrative specialties over primary internal medicine careers (general internal medicine, family practice, etc.). A shortage of nearly 40,000 primary physicians may occur in the coming decade and no easy solution is in sight as it takes a minimum of 11 years to train a standard internal medicine physician (4 years undergraduate + 4 years medical + 3 years of residency). Should Congress be taking this into consideration as it passes healthcare reform?
Epidemic of Overtreatment: Richard Dooling writes about his experience with the American obsession with overtreatment. In his own words there is "an 'epidemic of overtreatment,' in which unnecessary procedures, tests and medications all spawn more tests, more meds (to treat the side effects of the first batch) and more follow-up scans and procedures (in stand-alone clinics owned by the same doctors prescribing the tests, scans and procedures)." Is he correct is foretelling of the coming rationing of care for an increasingly older population? Will entitlements prove too much for our GDP?
Obsfucating Healthcare: John Aloysius Cogan Jr. writes about the amazing complexity of health insurance policies. Filled with poorly worded legalese written in graduate school language, that even experts may have a hard time deciphering. Cogan calls for the reform bills to introduce a 'plain language' clause requiring all policies to be written in clear and understandable language.
A Virus’s Debut in a Doctor’s Syringe: How did a tropical disease first arrive on the shores of the United States? Through at doctor's syringe! In the early 1950's when radiation and chemotherapy were still being developed, a no effective non-surgical remedies existed for treating cancer. But Dr. Chester M. Southam believed that a viral infection could reduce the size of a tumor, based upon work done in mice. And so, placing terminally ill patients behind a mosquito screen door, Dr. Southam began a clinical trial in which patients were injected with the virus (which was believed to be relatively harmless). In the end: "In one type of cancer, lymphoma, tumors did shrink in 3 of 8 injected patients, compared with just a few responses in the 100 with other types of cancer. But five of the same eight lymphoma patients developed severe West Nile disease, including encephalitis — a rate far higher than in everyone else." It's not likely that any mosquitoes escaped with the virus into the wild. Certainly today the ethics of such brazen use of human tests subjects would be highly questionable. But investigators are still testing the possibility of using virus's as targeted weapons to use against tumors. Read the entire complex story at the NY Times article from August 24, 2009.
Quick Briefs:
And You Thought a Prescription Was Private (NY Times, August 8, 2009): Your doctor isn't the only one who can access your prescription information.
DNA Evidence Can Be Fabricated, Scientists Show (NY Times, August 17, 2009): Israeli scientists demonstrate how crime scene DNA can be fabricated. They also happen to sell a test to distinguish between fake and real DNA samples.
Beyond Beltway, Healthcare Debate Turns Hostile (NY Times, August 7, 2009): Angry protesters and Congressional town hall meetings clash in one of the this summers strangest demonstrations of political activism. Grass roots? Astroturf? Or just plain madness?
Research Trove: Patients' Online Data (NY Times, August 24, 2009): Patients with rare diseases have begun to organize website data centers for pooling healthcare data about their conditions. But how accurate is self reported data? And what about the privacy concerns inherent in having third parties not bound by strict academic research protocols collecting the data?
Michael Shusterman is the Editor in Chief of TuftScope (2009 - 2010).
Saturday, August 29, 2009
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