Sunday, November 27, 2016

Center for Innovative Collaboration in Medicine and Law - FSU College of Medicine

The Center for Innovative Collaboration in Medicine and Law is a joint effort of the FSU College of Medicine and FSU College of Law. The mission is to identify and facilitate (through education, the conduct and dissemination of scholarship, and performance of service activities) opportunities for members of the medical and legal professions, working together and with others, to foster improvements in the quality of life enjoyed by individuals and to promote public health in Florida, the United States, and globally.

http://med.fsu.edu/index.cfm?page=innovativeCollaboration.home#

Saturday, November 19, 2016

Hepatitis And Multiple Sclerosis Specialists Among Biggest-Dollar Prescribers In Medicare : Shots - Health News : NPR

The number of doctors who each prescribe millions of dollars of medications annually in Medicare's drug program has soared, driven by expensive hepatitis C treatments and rising drug prices overall, federal data obtained by ProPublica show.

The number of providers who topped the $5 million mark for prescriptions increased more than tenfold, from 41 in 2011 to 514 in 2015. The number of prescribers — mostly physicians but also nurse practitioners — exceeding $10 million in drug costs jumped from two to 70 over the same time period, according to the data.

Most of the doctors atop the spending list prescribed Harvoni or Sovaldi, relatively new drugs that cure hepatitis C. Other providers on the list prescribed pricey drugs to treat cancer, multiple sclerosis and rheumatoid arthritis.

More ...

http://www.npr.org/sections/health-shots/2016/11/17/502341021/a-growing-group-of-doctors-are-big-money-prescribers-in-medicare

Thursday, November 17, 2016

NFL doctors should not report to teams, Harvard study recommends - The Washington Post

A new report from Harvard Law School proposes drastic changes in the way health care is administered in the NFL, urging the nation's most popular sports league to upend its system of medicine and untangle the loyalties of the doctors and trainers charged with treating players.

Asserting that the long-standing current structure has inherent conflicts of interest, the 493-page report outlines a new system in which a team's medical staff is devoted solely to players' interests and no longer reports to team management or coaches.

"The intersection of club doctors' dual obligations creates significant legal and ethical quandaries that can threaten player health," the report states.

The two-year study bills itself as the first of its kind in "examining the complicated and often-paradoxical universe of stakeholders that may influence NFL player health." The NFL strongly took issue with the methodology and conclusions drawn by the Harvard researchers.

On Nov. 1, Jeffrey Miller, the NFL's executive vice president of health and safety, sent the researchers a 33-page response in which he rejected any suggestion that NFL doctors have conflicts of interest and called the proposed change "untenable and impractical." He said researchers have called for "several unrealistic recommendations that would not improve player care."

The report "cites no evidence that a conflict of interest actually exists," Miller wrote. ". . . The Report identified no incident in which team physicians were alleged to have ignored the health status of players, failed to adhere to patient confidentiality consent procedures, or made recommendations to clubs that were contrary to the health of players."

More ...

https://www.washingtonpost.com/sports/redskins/nfl-doctors-should-not-report-to-teams-harvard-study-recommends/2016/11/17/fc3a4e42-ac35-11e6-8b45-f8e493f06fcd_story.html?

Sunday, November 13, 2016

A Doctor Shortage? Let’s Take a Closer Look - The New York Times

Many people have to wait too long to see a doctor. And it could get worse. If, as many people believe, we have a shortage of doctors in the United States, then it follows that we can fix this only by training and hiring more physicians.

As with almost everything in our health care system, though, it's complicated. Some people think there's no shortage at all — just a poor distribution of the doctors we have.

The main argument for a physician shortage is that we aren't adding enough new doctors to keep up with changing demographics. The Association of American Medical Colleges has projected that by 2025 there will be a shortfall of between 46,100 and 90,400 doctors. In primary care, it projects a shortfall of between 12,500 and 31,100 doctors.

The baby boomers are getting older and sicker, and they have more complex conditions than they did when they were younger, including arthritis, high blood pressure, pulmonary disease, diabetes and cancer. The Affordable Care Act is expected to accelerate the need for additional medical care. Increased insurance coverage increases demand, and Obamacare alone is projected to require about 16,000 to 17,000 more physicians than would have been required without it.

Adding data to this argument, the United States has fewer practicing physicians per 1,000 people than 23 of the 28 countries that reported data in 2013 (among nations in the Organization for Economic Cooperation and Development).

The United States had 2.56 doctors per 1,000 people, which is more than Canada (2.46), Poland (2.24), South Korea and Mexico (both 2.17). But we were way behind countries like Austria (4.99), Norway (4.31), Sweden (4.12), Germany and Switzerland (both 4.04).

Based on these metrics, it would seem that we need more physicians. It would also seem that we're not training them. When it comes to medical graduates, the United States ranks 30th of 35 countries.

But there is strong evidence that we are thinking about this the wrong way. In 2014, the Institute of Medicine released a thorough analysis on graduate medical education that argued there was no doctor shortage, and that we didn't really need to invest more in new physicians.

More ...

http://www.nytimes.com/2016/11/08/upshot/a-doctor-shortage-lets-take-a-closer-look.html?

Saturday, November 12, 2016

Hospitals Fast-Track Treatments for Hip Fractures - WSJ

For older people who fracture a hip, the prognosis is grim: a third or more die within a year and only about 1 in 5 return to their pre-injury level of function.

A new approach to care could mean it doesn't have to be that way.

More hospitals are putting hip fracture patients on a fast track from the emergency room to the operating room, repairing the fracture in as little as six hours after diagnosis. The approach appears to produce significantly better outcomes for patients than the conventional practice of waiting up to three days before operating on the fracture. It can also reduce the costs of complications and longer hospital stays.

More ...

http://www.wsj.com/articles/hospitals-fast-track-treatments-for-hip-fractures-1478547906?mod=e2tw

Saturday, October 29, 2016

Her toddler suddenly paralyzed, mother tries to solve a vexing medical mystery - LA Times

Erin Olivera waited weeks for doctors to tell her why her youngest son was paralyzed.

Ten-month-old Lucian had started crawling oddly — his left leg dragging behind his right — and soon was unable to lift his head, following Erin only with his eyes.

She took him to a hospital in Los Angeles, but doctors there didn't know how to treat what they saw.

Lucian's legs felt soft as jelly and he couldn't move them. His breathing became rapid. The left side of his smile drooped as his muscles weakened.

Physicians ran test after test, and Erin began spending her nights on a hospital room couch. After Lucian fell asleep, during her only minutes alone between working and visiting her three other kids, she cried.

A terrifying reality was taking hold: Doctors wouldn't be able to give her a diagnosis for her paralyzed child.

"How can I make a decision for him when I don't even know what's wrong?" she said. "What can I do to help him?"

So one morning in July of 2012, Erin lifted Lucian out of his hospital bed, his body limp and heavy. She rested his cheek on her shoulder, the way he liked to be held since he'd become weak.

Erin returned home to Ventura County with a child she thought might never learn to walk.

In the years since, hundreds of children across the country have shown up at hospitals unable to move their arms or legs. Dozens of kids have become paralyzed in the past few months alone.

They suffer from a mysterious illness that continues to alarm and puzzle scientists. This kind of sudden and devastating paralysis hasn't been widespread since the days of polio. Lucian, one of the disease's earliest victims, set off a hunt among doctors to discover its cause.

More ...

http://www.latimes.com/local/california/la-me-polio-paralysis-20160823-snap-story.html

Wednesday, October 26, 2016

Doctors thought he just had jock itch. Then it spread. - The Washington Post

Late Friday afternoon on Dec. 4, 2014, Stephen Schroeder was waiting to board his packed flight from Philadelphia to Las Vegas for a much anticipated long weekend with his son when his cellphone rang. On the line was an unexpected caller: his doctor, reporting test results sooner than Schroeder had expected.

Listening intently, Schroeder was flooded with disbelief as he struggled to comprehend what he was hearing. Using the lip of a trash can as a writing surface, he scribbled notes on the back of his boarding pass, making the doctor spell out each unfamiliar word. Then he sent a terse text to his wife, who was at their home in the Philadelphia suburbs, and got on the plane.

Onboard, Schroeder, then 55, fired up the balky in-flight Internet, desperate for information.

What he read over the next five hours left him alternately terrified, stunned and then, as denial took over, skeptical. "I kept thinking this must be some kind of really stupid mistake," he recalled. "The diagnosis had to be wrong."

Spokane sales manager Steve Schroeder, along with his doctors, thought he had a bad case of jock itch for more than a year. (Courtesy of Steve Schroeder)
Schroeder would discover that the pesky rash he and his doctors had dismissed as inconsequential would take over — and threaten — his life.

The experience would provide a crash course in the importance of finding experts who could provide appropriate treatment, in the necessity of learning as much as possible about a disease, and in the loneliness of coping with a diagnosis so rare it lacks a support group.

More …

https://www.washingtonpost.com/national/health-science/doctors-thought-he-just-had-jock-itch-then-it-spread/2016/10/24/bc722226-83e5-11e6-a3ef-f35afb41797f_story.html?

Monday, October 24, 2016

A new divide in American death - Unnatural Causes: Sick and dying in small-town America - The Washington Post

Since the turn of this century, death rates have risen for whites in midlife, particularly women. In this series, The Washington Post is exploring this trend and the forces driving it.

Drugs, alcohol, marketing and lax federal oversight are working to defy modern trends of mortality, perhaps most starkly among middle-aged white women.

https://www.washingtonpost.com/unnatural-causes/

The First Fentanyl Addict | VICE

If the opiate crisis has taught us anything, it's that addiction affects everyone. An unprecedented surge in fentanyl-implicated death—across all incomes and backgrounds, obviously—has sparked public health emergencies across the US and Canada. With each fentanyl overdose reported, we're seeing ignorant assumptions about who uses drugs and why finally put to rest.

But there was a time when fentanyl was almost exclusively used by a very small group, and it had nothing to do with Margaret Wente's idea of a "typical drug addict" or poverty or organized crime. What the general public is oblivious to—but the medical community knows—is how fentanyl addiction took its roots in anesthesiology before it made its way into the mainstream.

Dr. Ethan Bryson, associate professor in the anesthesia and psychiatry departments at the Icahn School of Medicine at Mount Sinai, New York, believes it was anesthesiologists who, familiar with fentanyl's pharmacology and abuse potential, first began misusing the opioid.

"If you look at the history of morphine, cocaine, and heroin, these were all drugs which were initially developed for legitimate medical purposes, but subsequently became recreational pharmaceuticals," Bryson told VICE. "They were all experimented on with people with that access. That's well documented in history."

More …

http://www.vice.com/read/the-first-fentanyl-addict?

Saturday, October 8, 2016

Lancet Global Burden of Disease Highlights Back Pain - The Atlantic

The newest iteration of the Global Burden of Disease study, which tracks the prevalence of deaths and diseases worldwide, contains some good news: On average people are living about a decade longer than they were in 1980. But there's a catch: Health hasn't improved as fast as life expectancy overall, which means that for many, those long, final years are spent hobbled by illness and disability.

The nature of our old-age ailments has changed in recent years. The study, published this week in The Lancet and conducted by the Institute for Health Metrics and Evaluation at the University of Washington, uses a metric called "Disability Adjusted Life Years." DALYs, as they're abbreviated, combine the number of years of life a person loses if they die prematurely with the amount of time they spend living with a disability. Think of it as time you didn't spend living your #bestlife—because you were sick or dead.

In rich countries, the number one cause of these DALYs is not surprising: ischemic heart disease, which is associated with well-known Western issues like high cholesterol and obesity. But the number two condition is a little strange: plain, old-fashioned, ever-present, low back and neck pain.

Even when you include poor and middle-income countries, low back and neck pain went from ranking 12th as a cause of DALYs globally in 1990 to ranking fourth in 2015, the most recent year. In most countries, it was the leading cause of disability. DALYs from low back and neck pain increased by more than 17 percent from 2005.

The things that make us low-level miserable are now more likely to be simple aches and pains, rather than frightening, communicable diseases like diarrhea. That's encouraging, but it's still a little sad. People all over the world increasingly live long, great lives, only to spend their golden years slathered in IcyHot.

More ...

http://www.theatlantic.com/health/archive/2016/10/how-back-pain-took-over-the-world/503243/?