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Week of March 24 - In Case You Missed It...TOMF Medical News Roundup

March 28, 2014


In Case You Missed It...
March 24, 2014

Still Time for Physicians to Sign up for Wool Seminar

The following was in the Arizona Jewish Post and is used with permission.

Understanding your patient and yourself as a physician - and a human being - is the path to the best medical treatment. So say Dr. Jerome Groopman and Dr. Pamela Hartzband, authors of "Your Medical Mind: How to Decide What is Right for You." Both Harvard Medical School educators will be the keynote speakers at the Fifth Annual Cindy Wool Memorial Seminar on Humanism in Medicine and dinner on Wednesday, April 2 at 5 p.m., at the Marriott University Park Hotel at Main Gate.

"Medicine is undergoing a transition with the use of electronic records and computers in the office," Hartzbrand, an endocrinologist, told the AJP. "It's been a bumpy transition. It's a bad thing in medicine now" when doctors are checking off boxes on their computers instead of looking at patients.

"How do we help patients when there's so much controversy among the experts about everything?" she asks. "Do you take statins or not for high cholesterol? Do mammograms save lives or are there too many false positives?" Discovering the best treatment for a specific patient "is a challenging process. We have to keep in mind why we went into this profession."

Hartzbrand and Groopman, her spouse, started field research five years ago to determine the best way to treat patients as individuals, with different needs and views toward medicine. While other studies have looked at physician-patient communication, says Groopman, an oncologist, "We interviewed scores of patients all over the United States to define the categories" for best treatment.

The two physicians came up with three spectra of patient types in their research: minimalist to maximalist, who either believe that less is more or they want to try everything; technologist to naturalist, who want the latest breakthroughs in either area; and believers to doubters, who are either convinced they have the right answer or are skeptical about every option. Patients can also mix and match from each spectrum, says Hartzbrand, who is an assistant professor at Harvard Medical School and attending physician at Beth Israel Deaconess Medical Center in Boston.

Groopman holds the Dina and Raphael Recanati Chair of Medicine at the Harvard Medical School and is chief of experimental medicine at Beth Israel Deaconess. He has authored numerous editorials on policy issues in the New York Times, Wall Street Journal, New Republic and Washington Post. His previous books were "The Measure of Our Days (the basis for the ABC Television series "Gideon's Crossing," which explores the spiritual lives of patients with serious illness)," "Second Opinions," "The Anatomy of Hope" and "How Doctors Think." In 1998, Groopman became a staff writer in medicine and biology at the New Yorker magazine.

Together with Hartzband, he is a bimonthly columnist for "ACP Internist," the publication of the American College of Physicians read by 150,000 internal medicine physicians in the United States and Canada. Groopman and Hartzband are currently working on a curriculum for medical students based on "Your Medical Mind."

The Cindy Wool Memorial Seminar on Humanism in Medicine is sponsored by the Maimonides Society of the Jewish Federation of Southern Arizona in conjunction with the University of Arizona College of Medicine. The cost for the dinner and seminar is $50; admission is free for medical students. RSVP at www.jewishtucson.org or contact Karen Graham at 577-9393, ext. 118, or kgraham@jfsa.org.

Dr. Friese is Running for the Legislature

TOMF neither endorses candidates or political issues but is allowed to inform physicians and the public about candidates and issues.

Randy Friese MD, University of Arizona Medical Center trauma surgeon, is running as a Democrat for one of the two respresentative seats in Legislative District 9, which encompasses most of the old district that was represented by Andy Nichols MD until his death in 2001.

If you want to meet Dr. Friese and sound him out on issues, there will be a cocktail party Saturday, April 12, 3:30-5 p.m., 5901 N. Camino Arturo. His potential seatmate, Representative Victoria Steele, will also be present. You may RSVP to Cheryl Cage, 360-9016.

In Case You Missed It...
March 26, 2014

Did You Know?

Americans have about 1 billion colds a year. That is five colds a year for most adults, and it is the leading cause of doctor visits, according to the National Institutes of Health. Further, don't blame that cold that keeps coming back on the same virus. Once sickened, you have limited immunity to that virus but can be affected by another. There are 150 rhinoviruses circulating this winter and spring and physicians theorize a cold can weaken the protective mucus membrane in the nose, making you more susceptible to another virus.

Hand washing and exercise are the best preventatives against the common cold.

Doc Fix Patched

In breaking news, the US House has decided to extend, for 12 months, the patch to prevent a 29% physician Medicare pay cut. The current patch is set to expire March 31. The US Senate most still approve the new patch.

Both the US House and Senate have agreed to disregard the Sustained Growth Formula used to calculate physician Medicare payment, but have yet to reach consensus about how to pay (e.g., calculate the hit to the deficit) for the change.

Affordable Care Act Back in Court

Halbig v. Sebelius.

That case name may be a footnote or a landmark. We won't know until the US Supreme Court has the final say sometime in the next seven months.

Seven groups and citizens have brought suit alleging the IRS erred in ruling that health premium subsidies are available to all eligible citizens who buy health insurance through exchanges. The plain words of the statute says the subsidies are available to citizens who buy insurance through exchanges established by the states. In most states, including Arizona, the exchanges were established by the federal government.

The case is in the US Circuit Court of Appeals in Washington DC. A majority of the panel of judges seemed sympathetic to the plaintiff's arguments.

Modern Health Care News has a good summary of the case and arguments. Click here to read the article.

In Case You Missed It...
March 27, 2014

Hospitals Can be Hazardous to Your Health

The latest New England Journal of Medicine has a survey by the Centers for Disease Control's Dr. Shelley S. Magill in which she looked at infection rates for 11,282 patients in 183 hospitals in 10 states. The news isn't good.

Every day, four percent of hospitalized patients fight an infection picked up at a hospital or healthcare facility. Out of 34 million hospitalizations, there are 721,800 infections; 80,000 of whom are suffering with more than one hospital acquired infection.

About half the infections do not have an obvious infection route, such as a medical device. The most common infection (22%) is pneumonia, followed by assorted surgical site infections (22%), and stomach illnesses (17%).

ACA Sign-ups Extended

For three weeks the Obama Administration has been saying that March 31 is a hard deadline for signing up for health insurance. Local navigators, people trained to help enroll on the health exchange or apply to AHCCCS, met Monday and agreed to make a tough push toward that hard deadline.

Now the feel they have created distrust in Tucson with their insistence next Tuesday was the absolute last day to enroll without penalty. For the next several weeks people just have to say they tried to enroll and no one will even ask, "when?"

It is understandable that the government wants to make sure that when hundreds of thousands try to log on next Monday and Healthcare.gov crashes that people still get the chance to enroll, but the current policy seems lenient to even those aiding with sign-ups.

In Case You Missed It...
March 28, 2014

Father of Osteopathy Speaks:

Tucson Osteopathic Medical foundation has a copy of Andrew Taylor Still's autobiography, one that was personally presented by Dr. Still to Mrs. J.R. Bairstow who gifted it to Dr. W.R. Bairstow in 1931. The book is plain-spoken and contains some little gems we will share here from time to time.

Near the end of Chapter I, there is a charming story about his first discovery in osteopathy.

"Early in life I began to hate drugs. One day when I was about ten years old, I suffered from a headache. I made a swing from my father's plow-line between two trees; but my head hurt too much to make swinging comfortable, so I let the rope down to about eight or ten inches of the ground, three the end of a blanket on it, and lay down on the ground and used the rope for a swinging pillow. Thus I lay stretched on my back with my neck across the rope. Soon I become easy and went to sleep, got up in a little while with headache gone. As I knew nothing of anatomy at this time, I took no thought of how a rope could stop a headache and the sick headache that accompanied it."

War of Words

With something as politically divisive as the Affordable Care Act it is small wonder Democrats and Republicans have tried to win the message battle ever since the bill passed on partisan lines four years ago. Since the bungled rollout of the website, the GOP has had the upper hand.

Now Democrats are fighting back. Here is the current spin.

TALKING POINTS: MORE THAN SIX MILLION AMERICANS SIGN-UP
FOR QUALITY, AFFORDABLE INSURANCE
Thursday, March 27, 2014

  • MORE THAN SIX MILLION HAVE SIGNED UP: As consumers continue to surge to HealthCare.gov before the March 31st deadline, more than 6 million Americans have signed up for quality, affordable health insurance plans through the federal and state marketplaces since October 1.
  • ACA YEAR 1 ENROLLMENT IS ALREADY WELL OUTPACING MEDICARE PART D ENROLLMENT: After the initial open enrollment period for Medicare Part D, during which the Bush Administration also made several administrative adjustments to ease transition, enrollment was just 70 percent of the enrollment estimated by CBO. As recent analyses have shown, ACA enrollment has already well-surpassed that with several days left before the March 31 deadline.
  • THE AFFORDABLE CARE ACT IS WORKING: The more than six million Americans who have signed up for private insurance through that Marketplaces is in addition to the millions of Americans who have gotten coverage through Medicaid and CHIP and the more than 3 million young adults who previously gained coverage by staying on their parents' plans. And millions of Americans with insurance now have the peace of mind and health security that comes with the new benefits that kicked in on January 1, like protections against discrimination based on a pre-existing condition, being charged more just because you are a woman.
  • NATIONWIDE CONSUMER SURGE FOR HEALTH CARE: We are seeing near record numbers of consumers coming to check out their options and enroll in coverage. Yesterday alone, we had 1.5 million visits to HealthCare.gov and took more than 430,000 calls at our 24/7 call center.
  • WITH FOUR DAYS LEFT BEFORE THE DEADLINE, WE'RE REDOUBLING OUR EFFORTS TO BRING QUALITY, AFFORDABLE COVERAGE TO ALL AMERICANS: While we are thrilled that millions of Americans have gotten coverage, there are still four days left of open enrollment for 2014. We're rolling up our sleeves and redoubling our efforts to reach as many Americans as possible by the March 31st deadline to ensure they know what options are available to them and how they can sign up.
  • MARCH 31 IS THE DEADLINE. SPREAD THE WORD TO YOUR FRIENDS AND FAMILY MEMBERS TO GET COVERED NOW: With 4 days left for consumers to sign up for coverage, we are working hard to ensure that our systems can handle the unprecedented demand as people enroll before the March 31 deadline. But make sure your friends, family members, co-workers and communities don't wait - tell them to sign up now for coverage by visiting HealthCare.gov or by phone at 1-800-318-2596/TTY 1-855-889-4325. You can also find help in your community at https://localhelp.healthcare.gov/

Dog Bites Man is Still News

A highly publicized pit bull attack on a 4-year old Phoenix boy February 20 and the social media campaign to save the dog has captivated the capital. An Arizona Department of Health Services press release yesterday had some stats to put things in perspective.

There were 34,151 emergency department visits between 2008 and 2012. There were 2,358 hospitalizations and hospitalizations were up 139% in 2012 compared to 2008. About 70 percent of the bites occurred in the home and most involved children.

"No matter who you are or who your pet is, there's a level of responsibility. You owe it to yourself, to your family and to your community to be a responsible dog owner," said Will Humble, ADHS director.

Nichols Awards Given

TOMF Executive Director Steve Nash was given the 2014 Pioneer of Public Health Award, for his work in two initiative campaigns to raise AHCCCS eligibility to 100% of the federal poverty level, during the Andy Nichols Health Initiative reception March 27.

"Steve gave the initiative a home," said Cathy Nichols in making the announcement. The co-presenter, Eve Shapiro MD said, "With his laid back, calm style, Steve convinced the majority of the physicians in Pima County that supporting AHCCCS expansion was the right thing to do."

Earlier in the evening, former Governor Bruce Babbitt was given the Andy Nichols Award for establishing AHCCCS in Arizona. Ron Pust MD was honored with the Herb Abrams Award for his work in indigent and global health care.