Martin Wolfe, doctor specializing in tropical and travel medicine, dies at 82 – Washington Post

Martin S. Wolfe, a tropical disease specialist who founded one of the countrys first medical practices devoted to ailments incurred in travel and who, in the 1970s, accompanied Henry Kissinger as his personal physician, died June 15 at his home on Block Island, R.I. He was 82.

The cause was a failure of his artificial heart pump, said his son, David Wolfe.

Dr. Wolfe developed an interest in tropical diseases as a medical student and, early in his career, spent five years doing field research in Ghana and Pakistan.

As a staff medical officer for the State Department, he traveled the world with then-Secretary of State Kissinger. He also served as a tropical medicine expert for the World Bank.

In 1980, Dr. Wolfe opened Travelers Medical Service, believed to be the first medical office of its kind in Washington. He also had an affiliated parasitology laboratory and a private practice.

Dr. Wolfe advised people making overseas trips about potential health risks and administered immunizations. If travelers returned with mysterious ailments, he often had to become a medical detective.

He determined a diagnosis by retracing a patients journeys to pinpoint where exposure to various maladies might have occurred. Dr. Wolfe often consulted with the Centers for Disease Control and Prevention about infectious diseases found in other parts of the world but rarely seen in the United States, such as malaria, cholera and yellow fever.

He wrote more than 100 academic papers and textbook chapters about tropical medicine and travel medicine, which as become a recognized medical specialty.

Through his research and his work with diplomats and other international travelers, Dr. Wolfe became an authority on such exotic conditions as giardiasis and schistosomiasis, both of which are caused by parasites. The ailments, often linked to exposure to contaminated water, can lead to severe physical problems if left untreated.

Perhaps the most commonplace complaint of travelers returning to the United States with diarrhea. Dr. Wolfe recommended that people travel with a supply of Pepto Bismol or Imodium.

The question we always ask in tropical medicine, he told The Washington Post in 2008, is where have you been and what have you been doing?

Martin Samuel Wolfe was born April 9, 1935, in Scranton, Pa. His father was a tavern owner.

He was an Eagle Scout and captain of his high school basketball team before entering Cornell University, where he received a bachelors degree in 1957 and a medical degree in 1961.

One of his medical school professors encouraged his interest in tropical medicine, and Dr. Wolfe did research in Ghana from 1962 to 1964. After a residency in New York, he trained at the London School of Hygiene and Tropical Medicine. Dr. Wolfe conducted additional medical research in Pakistan from 1967 to 1970, when he joined the State Department.

He taught courses in tropical medicine and parasitology the Georgetown and George Washington University medical schools and was a consultant for many years to the State Department, Peace Corps and World Bank.

Dr. Wolfe was a member of the International Society of Travel Medicine and the American Society of Tropical Medicine and Hygiene, which presented him with its top award. He was a member of the Cosmos Club and Adas Israel Congregation.

Dr. Wolfe retired in 2015. The Travelers Medical Service in Washington is now operated by his son, a physician; its New York branch is run by a daughter, a registered nurse and public health specialist.

Survivors include his wife of 55 years, Lotte Brunes Wolfe of Washington; three children, Rebecca Wolfe Acosta of New York City, David Wolfe of Bethesda, Md., and Miriam Strouse of McLean, Va.; a sister; and seven grandchildren.

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Martin Wolfe, doctor specializing in tropical and travel medicine, dies at 82 - Washington Post

Yes, those ‘kids’ are doctors and they can see you now – The News Tribune


The News Tribune
Yes, those 'kids' are doctors and they can see you now
The News Tribune
The three-year residency program, which will graduate its first class this summer, is part of a considerable regional growth in residency programs for family medicine, which runs from delivering babies to seeing the elderly. For patients across the ...

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Yes, those 'kids' are doctors and they can see you now - The News Tribune

Y-Speak: Herbal medicine vs. synthetic drugs: What’s better? | SunStar – Sun.Star

EVER since the start of the Modern Age, it has always been a debate whether whats the better treatment: herbal medicine or synthetic drugs.

When you ask your mothers and grandmothers, theyll tell you that the natural way is the right way in treatment. But, when asking the more modern-minded people, theyll pick the scientific drugs over any alternative medicine. So, whats the real deal?

According to a World Health Organization, there are 250,000 practitioners of traditional medicine in the Philippines. Natural medicine users have been growing ever since the Traditional and Alternative Medicine Act of 1997 (or Tama) was implemented. Because of this, the country has been majorly supporting the use of alternative medicine, and is more inclined towards it over the latter years.

There are a lot of advantages to herbal medicine, according to Health Guidance. Its a lot less cheap than most synthetic medicine and its also very easily attainable. Most, if not all, herbal medicines are mostly considered over-the-counter medicine, which do not need any doctors prescription to buy it. These alternative medicines also dont really have serious side-effects and are mainly promoting general wellness.

But, they have disadvantages as well. Its ineffective against very serious conditions. You cant really fix a broken arm with herbal medicine, can you? It may also trigger allergies, if youre not careful.

Steven Salzberg, a prominent biology researcher at University of Maryland, calls alternative medicine as cleverly marketed, dangerous quackery.

He even said that the more time they spend getting fraudulent treatments, the less time theyll spend getting treatments that work and that could save their lives.

This brings us to the advantages of modern medicine.

According to Elizabeth Blackburn, a biologist at the University of California at San Francisco and a Nobel laureate, modern medicine was formed around success in fighting infectious diseases. This means that while alternative medicine promotes the general well-being of a person, modern medicine aims to attack a specific disease.

The biggest advantage of modern medicine is actually the biggest disadvantage of alternative medicine its effective on more serious conditions.

Imagine breaking a leg. Would you consider going to an herbalist instead of a doctor whose expertise are more inclined towards your injury?

In the Philippine Health System Review for 2011, it is said that in the 2006 FIES, the average Filipino household spends about P4,000 per year on medical care. Drugs account for almost 70 percent of total household out-of-pocket (OOP) payments while less than 10 percent of total OOP is spent on professional fees. Especially in the world today, most people opt to go to modern medicine.

But, it has its disadvantages as well. Modern medicine is more expensive when it comes to the more serious diseases. There are other cases where the chemicals are too strong for some bodies to handle.

So, with the advantages and disadvantages of both interchanging, which really is the better one?

"For as long as BFAD approved, okay lang man yan (Herbal medicine is okay. Meron yang (It has) scientific basis na pwede siya for consumption. Pero, hindi parin (But it is not) priority ang non-medicinal [Herbal] over medicinal [Synthetic] because there are illnesses or medical conditions that cannot be treated or managed using non-medicinal or herbal regimens, Mari Pearl Agawin, an obstetrician/gynecologist, shared.

Dr. Agawin also added that there are no scientific bases that the synthetic medicine is proven more effective if not any, over the herbal medicine. With this, as long as your illness gets cured, the opinion of the more effective treatment depends on you.

Whether human-made or natural, the most important criteria for a medicines use is safety, effectiveness and quality: identity, purity, potency and stability, Joe Albers, Pharmacist, Pharm.D., Ph.D., said. (Fhrea Zenntine Malinit)

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Y-Speak: Herbal medicine vs. synthetic drugs: What's better? | SunStar - Sun.Star

Michigan Medicine health system posts better bottom line | Crain’s … – Crain’s Detroit Business

Michigan Medicine, the new name for the combined University of Michigan Health System and UM Medical School, posted a 5.6 percent operating margin that exceeded results over the last several years. UM officials had projected a 3.7 percent margin for fiscal 2017.

The Ann Arbor-based academic health group, which includes three hospitals, 125 clinics and a large faculty practice plan, earned $210 million in operating profits, $67.7 million more than projected, on revenue of $3.7 billion. Michigan's medical school generates total annual research funding of more than $470 million.

At a UM board of regents meeting Thursday, UMHS President David Spahlinger, M.D., also told regents Michigan Medicine is projecting a 5.4 percent margin on $3.8 billion revenue for fiscal 2018 that begins July 1. He said the rosy picture is due to improving quality and safety and managing costs.

"These targets are aggressive but needed to fund our aspirations for the next five years and beyond," Spahlinger said in a statement. "We are challenging ourselves to reach those goals and give us the ability to invest in our future."

UMHS posted an operating margin of 4.6 percent in 2015 after posting deficits in 2012 and 2013.

Spahlinger, who also is executive vice dean for clinical affairs of the UM Medical School, added that the health system experienced somewhat higher patient volume than usual. Hospital discharges increased 0.8 percent in 2017 to 49,178. But 2018 projections call for a 2.1 percent increase in discharges to 50,213, he said.

Projects that are helping to add patient volume and completed in the past year include five operating rooms and five inpatient rooms to University Hospital, six patient rooms in the C.S. Mott Children's Hospital newborn intensive care unit and moving the psychiatry department into University Hospital South.

New projects underway include a new health center in west Ann Arbor set to open this fall and the Brighton Center for Specialty Care set to open in 2018. At newly affiliated Metro Health in Wyoming, Mich., plans call to activate 65 skilled nursing beds during the next year.

UMHS also has been busy the past year adding affiliate hospitals. Last December, UM finalized a deal to acquire Metro Health Corp. UM also owns about a 9 percent minority interest in MidMichigan Health in Midland.

Its UM Health subsidiary, which manages subsidiary companies, posted an operating margin of 0.2 percent on revenue of $377 million. Projected revenue for 2018 is $413 million for a slight loss of -0.3 percent margin. UM plans to make at least $40 million in capital investments at Metro Health.

From 2011 to 2015, Metro Health lost a total of $189.9 million on operations, according to American Hospital Directory Inc., a Louisville-based data company, based on Medicare cost report data. However, Spahlinger told Crain's that Metro Health earned a 2 percent margin in 2016.

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Michigan Medicine health system posts better bottom line | Crain's ... - Crain's Detroit Business

Know Your Madisonian: Veterinarian is pioneer in shelter medicine – Madison.com

Sandra Newbury didn't set out to become a major figure in the world of animal shelters.

While living in Chicago working as an artist for 12 years, a fascination with helping stray neighborhood cats got her foot in the door with animal shelters.

After volunteering and working in shelters, Newbury attended the veterinary school at UW-Madison. She saw great need and wanted to make an impact on the well-being of shelters and their animals.

Newbury went on to help found the shelter medicine program at the University of California-Davis, while working remotely from her home in Madison.

She travels nationally and internationally improving animal shelters. In 2014, Newbury started the shelter medicine program, serving as the director of the program at UW-Madison's veterinary school.

While UW-Madison didn't have a formal shelter program until 2014, the school was likely teaching shelter medicine courses before anyone else, she said.

In May, Newbury was named one of 15 national winners of the Maddie's Fund's Maddie Hero Award. The award gives $10,000 grants to each winner's organization for their efforts to advance a no-kill mission in shelters.

A pioneer in shelter medicine, which only recently became a board-certified specialty, Newbury said she is one of about 10 board-certified shelter medicine practitioners.

"If you look at veterinary medicine and the number of animals that need help or assistance that end up in shelters, there is no other disease, there is no other thing that affects more animals than animal shelters or animal care," she said. "No cancer kills as many animals."

What is shelter medicine?

Shelter medicine is working with animal shelters they are kind of our patients instead of just an individual animal. Though, a lot of the time, we do work with individual animals. We look at the whole organization as our partner and our patients. We work with animal shelters to increase their lifesaving capacity. Our goal is to help shelters save more lives.

We work with them on infectious disease, sanitation, even the way they do adoptions, the way they do intake and we do work in the community to support lifesaving instead of having animals pouring into shelters.

Do you work with the Dane County Humane Society as a branch of your work at UW-Madison?

A long time ago I was the director of medical services (at DCHS) which is really nice. (DCHS) is our field shelter for the UW-Madison shelter medicine program. Our interns work here, our residents do other clinical work here... I consult with (the shelter) on a regular basis. I'm pretty involved in a lot of the decisions that are made. If we really want to try something that would be a great new idea we try it here (at DCHS) first. This shelter is a really nice example of how a shelter can be run.

How has shelter medicine changed the landscape for animal shelters?

Before I went to vet school, when I would work in shelters, vets would come to shelters to help, but they didn't understand how shelters worked.... Coming out of vet school I came back to shelters with a whole new perspective.... A lot of shelters didn't used to vaccinate when animals came in... now we've done enough research to see how incredibly important it is to vaccinate an animal as it comes through the door. Now we can do the outreach and education to show shelters that. We've worked on a document called the Guidelines for Standards of Care in Animal Shelters. A lot of people running shelters didn't know what the right things to do were.... Our goal is to get that information out to veterinarians and non-veterinarians. Sometimes shelters have vets, but sometimes they don't have vets. Sometimes we have to educate the board of directors or the shelter director so they understand the health implications of the decisions they are making.

Do you think because of shelter medicine shelters are becoming stronger, better places for animals to be?

Oh yeah I'd like to believe a lot of that comes from shelter medicine. Even in the standards of care we wrote we were clear that we didn't expect every shelter to go from where they are to getting all of this achieved, but what we want is for every shelter to go from where they are to a little bit better. If they are always doing that then everything is getting better and animals' lives are being saved.

Interview by Amanda Finn

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WVU School of Medicine names new lead of surgery department – The Dominion Post

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Precision medicine demands ‘evolutionary leaps of interoperability’ – Healthcare IT News

John Halamka, MD, was just the second human being to be sequenced in the landmark Personal Genome Project in 2008, one of the initial group of volunteers known as the PGP-10.

Back then, it cost about $350,000 for a company to do such a sequencing. Now the price tag is less than $1,000. Clearly, many advancements have been made in precision medicine over the past 10 years and that includes information technologies just not necessarily in tandem with the bold vision of genomics.

[Also:Get social data into EHRs to bring precision medicine to population health]

"We aren't as good as we need to be," Halamka said this week at the Precision Medicine Summit. "Our EHRs are not exactly friendly for clinicians and they haven't done a good job of taking things like biomarkers, genomic interpretations and decision support and turning them into action."

How is precision medicine data relayed in the EHR, for instance?

"We use a very highly interoperable standard for such material called 'PDF,'" said Halamka.

[Also:Promise of precision medicine depends on overcoming big obstacles]

Washington University bioinformaticist and genetics fellow Nephi Walton said that in one project with Epic Systems it took them 9 months to get genetic data into the EHR and that, too, was via PDF.

Healthcare has to overcome several obstacles, in fact, to harness genomic advancement in a big way. While providers can send basic clinical summaries around, those are relatively simple data points like problem lists, meds, allergies and lab results rather than the genomic data that holds promise for personalized care.

[Also:Is precision medicine a matter of national security?]

What we need are systems that allow physicians quick and accurate knowledge of genetic conditions, Walton added. The informatics is crucial. This information cant just come from whats in the literature.

Halamka said that interoperability has to make some evolutionary leaps if healthcare is going to capitalize on the ideals of precision medicine research.The good news? Hes starting to see upstarts and innovators enable more than just provider-to-provider exchange.

"I am meeting with more and more entrepreneurial 26-year-olds who are creating modules of functionality that are layering on top of electronic health records and will fundamentally provide more agility and more innovation than the EHR vendors themselves, Halamka said.

The hope, he added, is that these companies will bring to market functions that live outside the EHR and enable bidirectional data exchange through FHIR and other standards.

Walton said that genomics and artificial intelligence, for instance, are advancing so fast right now that hospitals, payers, academic medical centers and government health entities need a framework to put those emerging technologies into practice quickly to manage to maintain and deliver precision medicine information.

"The future is bright," Halamka said. And its happening quickly.

Twitter:@MikeMiliardHITN Email the writer: mike.miliard@himssmedia.com

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Precision medicine demands 'evolutionary leaps of interoperability' - Healthcare IT News

California Dreams of Single-Payer Medicine – WSJ – Wall Street Journal (subscription)

California Dreams of Single-Payer Medicine - WSJ
Wall Street Journal (subscription)
I would hope that, should California's single-payer proposal pass, no resident of California will be exempt from coverage and no alternative ever be allowed.

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Women are flocking to wellness because modern medicine still doesn’t take them seriously – Quartz


Quartz
Women are flocking to wellness because modern medicine still doesn't take them seriously
Quartz
The wellness movement is having a moment. The more luxurious aspects of it were on full display last weekend at the inaugural summit of Gwyneth Paltrow's lifestyle brand Goop, from crystal therapy to $66 jade eggs meant to be worn in the vagina.

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Women are flocking to wellness because modern medicine still doesn't take them seriously - Quartz

Regents OK $61M for UCCS sports medicine component of City for Champions – Colorado Springs Gazette

Sports Medicine and Performance Center. North Nevada Avenue Campus of the University of Colorado Colorado Springs. Courtesy of City for Champions.

The University of Colorado regents Thursday approved spending $61.4 million on a City for Champions project: the proposed William J. Hybl Sports Medicine and Performance Center at the system's Colorado Springs campus.

The regents are attending a special board meeting Thursday and Friday at UCCS.

Preliminary plans call for a 104,000-square-foot building on the east side of North Nevada Avenue, north of the Lane Center for Academic Health Sciences.

A 30-year bond will fund the building with repayment coming from several sources, including tourism dollars, and funds from the project partners, UCCS and Centura Health, which owns Penrose-St. Francis Health Services system in Colorado Springs.

Thursday's action allows the initiative to continue moving forward and obtain further approvals, including a go-ahead from the Capital Development Committee of the state Legislature.

Project design is expected to begin in the fall, with construction getting under way in July 2018 and completion by Dec. 31, 2019.

The Hybl Center is part of City for Champions - a series of projects in Colorado Springs including the U.S. Olympic Museum downtown, designed to attract thousands of visitors to the area.

In December 2013, the Colorado Economic Development Commission agreed to provide some funding for the projects under the state's Regional Tourism Act.

The Hybl Center, named in honor of a noted local philanthropist, amateur sports official and diplomatic leader, will be the first facility of its kind to combine undergraduate and graduate education with hands-on clinical practice and search in a sports medicine and performance setting.

Various bachelor's, master's and doctoral degree programs will be offered, and academic research will focus on such areas as human performance, cardiovascular physiology, environmental stress and others.

The center will serve tens of thousands of patients each year and provide space for human performance testing and training, biomechanics, medically based fitness, athletic training, physical therapy, sports medicine primary care and orthopedics.

Centura Health will assume financial responsibility for the performance clinics' space, equipment and staff. UCCS will be responsible for research and instruction, along with leadership and some employees for the clinics.

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Regents OK $61M for UCCS sports medicine component of City for Champions - Colorado Springs Gazette

Michigan Medicine health system posts better bottom line – Crain’s Detroit Business

Michigan Medicine, the new name for the combined University of Michigan Health System and UM Medical School, posted a 5.6 percent operating margin that exceeded results over the last several years.

The Ann Arbor-based academic health group, which includes three hospitals, 125 clinics and a large faculty practice plan, earned $210 million in operating profits on revenue of $3.7 billion. Michigan's medical school generates total annual research funding of more than $470 million.

At a UM board of regents meeting Thursday, UMHS President David Spahlinger, M.D., also told regents Michigan Medicine is projecting a 5.4 percent margin on $3.8 billion revenue for fiscal 2018 that begins July 1. He said the rosy picture is due to improving quality and safety and reducing costs.

"These targets are aggressive but needed to fund our aspirations for the next five years and beyond," Spahlinger said in a statement. "We are challenging ourselves to reach those goals and give us the ability to invest in our future."

UMHS posted an operating margin of 4.6 percent in 2015 after posting deficits in 2012 and 2013.

Spahlinger, who also is executive vice dean for clinical affairs of the UM Medical School, added that the health system experienced somewhat higher patient volume than usual. No actual data was available at press time.

Projects completed in the past year include five operating rooms and five inpatient rooms to University Hospital, six patient rooms in the C.S. Mott Children's Hospital newborn intensive care unit and moving the psychiatry department into University Hospital South.

New projects underway include a new health center in west Ann Arbor set to open in fall 2017 and the Brighton Center for Specialty Care set to open in 2018.

UMHS also has been busy the past year adding affiliate hospitals. Last December, UM finalized a deal to acquire Metro Health Corp. in Wyoming. UM also owns a minority interest in MidMichigan Health in Midland.

Its UM Health subsidiary, which manages subsidiary companies, posted an operating margin of 0.2 percent on revenue of $377 million. Projected revenue for 2018 is $413 million for a slight loss of -0.3 percent margin. UM plans to make at least $40 million in capital investments at Metro Health.

From 2011 to 2015, Metro Health lost a total of $189.9 million on operations, according to American Hospital Directory Inc., a Louisville-based data company, based on Medicare cost report data. However, Spahlinger told Crain's that Metro Health earned a 2 percent margin in 2016.

In other action, the regents:

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Michigan Medicine health system posts better bottom line - Crain's Detroit Business

I shunned studying medicine to become a nurse. Here’s why – The Guardian

Nurses are required to be highly skilled, educated professionals but they are still seen as handmaidens to doctors. Photograph: Medic Image/Getty Images/Universal Images Group

A nurse?

You want to be a nurse?

There it is again. The surprise, the raise of the eyebrow, the uncomfortable pause. Followed by one of two responses: the overly-enthusiastic and evidently forced good for you, or the honest but, why? Surely youd rather be a doctor?

The surprise is understandable; I dont have the most conventional background for nursing. At school I pursued both science and humanities to A-level before landing a place at Cambridge to read history of art. Wooed by the hedonism of student media, I pursued a career in entertainment television, dismissing my long-standing passion for nursing as a romantic daydream, sparked by the literature of Vera Brittain and Florence Nightingale.

However, with each year my passion grew rather than waned and I realised it was more than a passing phase. So at Christmas I decided to turn my back on an industry I had fought so hard to get into, and applied for the two-year postgraduate diploma in adult nursing.

At first I wasnt brave enough to shun societal expectation and for a while I considered applying to study graduate medicine. I recall one particular conversation with my mother where she described how shed spent her life being just a nurse and aspired for her daughter to aim higher evidence of how the longstanding prejudice surrounding the profession is passed between generations.

After working as a healthcare assistant in a busy London trust my suspicions were confirmed: it was the work of the nurses, rather than the doctors, that inspired me. Seeing nurses on the ward, I grew to appreciate the autonomy of their role; distinct, yet equally valuable as the physicians.

Unlike doctors, a nurse will spend extended periods of time with their patients, building a relationship founded on implicit trust. They are at the bedside from admission through to discharge, relieving pain, easing distress and raising the alarm at any red flags.

Consequently, they are in the best position to observe the subtleties of a patients condition and gain the most holistic understanding of their needs. This unique nurse-patient relationship, combined with intelligent communication with the physicians, is arguably at the forefront of successful treatment and recovery. Therefore, nurses are required not only to be empathetic and perceptive, but highly skilled, educated professionals who can operate independently.

Yet despite this, nurses are still widely perceived as handmaidens to doctors. The stereotypes linger, reinforced by popular culture. Take any glossy hospital hit of the last decade House, ER, Greys Anatomy. Nurses are portrayed as unskilled aides to the deity-like doctors, thats if theyre given screen time at all.

The prejudice also manifests itself in a continued gender imbalance. Just over 10% of UK registered nurses are male, a stubborn figure that barely shifts each year. Its a fact Im reminded of every time I hear the call of sister or matron echo down the ward.

The view of nurses as subordinate seems to be particularly entrenched in the UK, ironic given the founder of modern nursing, Florence Nightingale, rallied against the view of nurses as devoted and obedient (a definition she scoffed might do for a horse). One nurse I work with is considering returning to Nigeria, so disheartened by the lack of trust and respect in the NHS, attitudes that do not exist in her country. Others are attracted by opportunities overseas, notably Canada and Australia, where salaries reflect the higher status of the profession.

There is hope, as the profession has evolved dramatically over the last decade and there are increasing numbers of opportunities to specialise and even prescribe. New titles, including nursing consultant, advance nurse practitioner and clinical nurse specialist challenge the traditional hierarchy.

However, prejudice is so deep rooted that I fear change will take decades and in some cases be met with resistance. Just last week I overheard a consultant say to an impressionable junior doctor: We dont do care, we do medicine. It wasnt so much the statement that was upsetting; it was the delivery. Tinged with disdain, the implication was obvious: the provision of care is lowly, beneath the role of the physician.

We must challenge these views and start to see nurses as partners to doctors, not inferiors. Their unique scope of practice is of equal importance and until we recognise this, we will struggle to retain and attract the brightest talent to the profession.

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.

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I shunned studying medicine to become a nurse. Here's why - The Guardian

Disparities of women in medicine and science to be explored in Brown conference – The Providence Journal

'Although medical schools graduate nearly equal numbers of women and men, there is still a paucity of women in leadership in academic medicine and the biomedical sciences,' says professor and dean Sharkey.

PROVIDENCE, R.I. The persisting disparities of women in science and medicine and what women in those fields can do to help change the equation will be discussed during a daylong conference Thursday sponsored by the Warren Alpert Medical School of Brown University.

"This conference is needed because although medical schools graduate nearly equal numbers of women and men, there is still a paucity of women in leadership in academic medicine and the biomedical sciences," Dr. Katherine M. Sharkey, Brown's assistant dean for Women in Medicine and Science, and an associate professor of medicine, psychiatry and human behavior, told The Journal.

"The 'trickle down' of this is that women physicians have fewer [federal] grants and publications and are paid more than $18,000 per year less than male physicians, even after controlling for lower-paying specialties and taking time off for maternity leave. Since most families are dual-career families nowadays, this hurts everyone, not just women."

That assessment is shared by keynote speaker Dr. Catherine DeAngelis, professor emerita of the Johns Hopkins University School of Medicine and the first female editor of the Journal of the American Medical Association, the nation's leading professional medical publication.

"I've learned that there are 4 essential characteristics of a good leader: Tough minded (NOT TOUGH), Tenacious, Thick-skinned and Tender-hearted," DeAngelis wrote in an email to The Journal.

"The latter two are expected of women, but when women display the first two, they are considered by many men to be difficult, nasty, arrogant and/or offensive. Hence, in addition to what Katie stated, only 22 percent of professors, sixteen percent of department directors and 15 percent of deans of medical schools are women. A great sense of humor helps a great deal."

The conference also features keynote remarks by Dr. Vanessa Britto, medical director of Wellesley College.

"These disparities impact healthcare," Sharkey said. "We are witnessing a national attack on women's health that I believe would be easier to combat if women comprised half of the medical school deans."

Said DeAngelis: "Women must work to be leaders using the '4 T characteristics' and mentor younger women to follow in their footsteps."

The professional development conference, "Achieving Equity in Medicine and Science an Era of Change,"runs from 8:15 a.m. to 3:30 p.m. Thursday at the Warren Alpert School, 222 Richmond St. Information at bit.ly/2soQ60A.

gwmiller@providencejournal.com

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On Twitter: @GWayneMiller

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Disparities of women in medicine and science to be explored in Brown conference - The Providence Journal

WHO classes HIV drug as an essential medicine – New Scientist

PrEP trials still to run in England

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THE World Health Organization has added anti-HIV drugs to its list of essential medicines, in a move that turns the spotlight on the UKs rationing of such drugs.

Pre-exposure prophylaxis, or PrEP, involves two drugs in a combined pill that significantly reduces the risk of catching HIV through unprotected sex. Public Health England (PHE) said it was too costly for the NHS even though it saves money in the long-term because fewer people need lifelong HIV treatment.

PHE said it would begin a 10,000-person trial of the therapy early in the 2017 financial year, but it still hasnt started.

The WHOs list of essential medicines should help countries prioritise the provision of vital drugs. Several other countries, such as the US, provide PrEP. Scotland and Wales have recently said they will supply it too.

In England, gay men tend to buy cheap generics online, through websites such as I WantPrEP Now, which works with NHS doctors to check the quality of the medicines.

This article appeared in print under the headline Essential HIV meds

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WHO classes HIV drug as an essential medicine - New Scientist

A precision medicine fight is brewing between clinicians, public health – Healthcare IT News

BOSTON -- Trying to apply new precision medicine methodologies when there are no precedents can be scary for physicians and patients alike. And the practice of genome sequencing and population screening are on the verge of getting more contentious.

Genomic sequencing is an artisanal process if you want to be at the standard of care, said Robert Green, MD, a medical geneticist and physician-scientist at Brigham and Womens Hospital and Harvard Medical School. Genomic medicine is outside, knocking on the door trying to get in.

Green pointed to the BabySeq Project, which offers free genome sequencing for newborns, and said that 93 percent of parents turn that down as a current example of how hard it can be to convince people to share their data and participate in precision medicine programs.

[Also:Why legal challenges could slow down precision medicine]

In the near term I think we will have a lot of skirmishes and maybe even a war about population screening, pitting clinical perspective of those who want to know everything against the public health perspective which says be careful what you screen for because you might have unforeseen consequences and costs downstream, Green said.

Its a matter of trust, but Vik Bakhru, chief operating officer of ConsejoSano, said precision medicine trust is only in its early stages.

How do we inspire trust that the data is actionable and they can benefit from treatments out there? Bakhru said.

One way is to educate prospective participants about the upsides. Penn Medicine, for instance, has changed the treatment plans on 80 percent of the patient it has sequenced, according to associate vice president Brian Wells.

Green said there are three big questions that have to be answered to earn that trust: Is genetic information toxic? Will participants and their providers misunderstand genomic information? Will benefits outweigh harms and justify the cost?

Its not that doctors dont know what to do with or how to interpret the data, and it isnt even about the cost, Green said. Instead, its the lack of clinical utility data thats the major obstacle of genomic medicine. Without that, precision medicine proponents cant get insurance companies to reimburse for genomic sequencing so its not a standard of care.

Green said that answering those questions and overcoming that clinical data utility obstacle will happen because the benefits ultimately outweigh the risk. Early evidence, in fact, suggests that using genome sequencing can pinpoint molecular diagnoses in about 25 percent of cases.

This is well established in the armamentarium of genomics, Green said. We have to work decision support into the process but we are going to get there.

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A precision medicine fight is brewing between clinicians, public health - Healthcare IT News

New AMA president: Physicians must lead to reshape medicine – American Medical Association (blog)

Physicians are obliged to show true leadership by modeling the right behavior, working together, developing consensus-based solutions, drawing on the skills of each health care team member, and demonstrating integrity and respect in their interactions, the AMAs incoming president said in his inaugural speech during the 2017 AMA Annual Meeting in Chicago.

These obligations are especially heightened during a time when many patients access to health care is threatened by the uncertainties of health-system reform, said David O. Barbe, MD, MHA, the new AMA president, and the 172nd in the Associations history. He is a board-certified family physician from Mountain Grove, Missouri, a town of less than 5,000 people where the median annual household income of $28,000 is just a little more than half the state-wide average of $50,000.

There are three areas in which physicians role as leaders is especially critical, Dr. Barbe said. In advocating for health reform in todays political environment, in describing and shaping the future of health care, and in mentoring those who will one day follow us in this profession.

The call for integrity and respectful collaboration stands in stark contrast to the partisan divide that has befallen conversation about health-system reform in the nations capital, he said. That division struck during the debate seven years ago and it is happening again today, Dr. Barbe said.

There are some factions in Washington that both then and now are saying not only no, but Hell no to working togethereven on some of the most basic principles of access, availability and affordability, Dr. Barbe said.

I submit to you that that might be good theater, but it is not good policy. Its not good politics and it is definitely not good leadership, he said. Good leadership is constructive, consensus-building and principled.

Dr. Barbe is in a position to know about such qualities. He began his career in a solo, independent practice 34 years ago and continues in that practice today. He also serves as vice president, regional operations, for Mercy health system with responsibility for five hospitals, 90 clinics and more than 200 physicians and advanced practitioners.

Every day, Dr. Barbe noted, he sees patients who need tests or treatments, who are still uninsured or havent met their deductibles, and due to this, they often delay necessary care.

Because of these patients, I see firsthand, every day, why the AMAs unwavering goal of affordable health insurance coverage for all is worth fighting for, he said. Keeping this issue front and center is critical as we debate health system reform againand again and again.

Dr. Barbe noted the AMAs core health reform principlepart of the Associations comprehensive visionthat no one who has gained insurance coverage in recent years should lose it as a result of new health-system reform legislation. But, he explained, that principle is flexible and practical in that we are willing to consider options for better, more cost-effective ways to cover the uninsured than we are doing now.

Physicians should not allow themselves to be corrupted or co-opted by the hyper-partisan political climate, Dr. Barbe added. We, as physicians, and as a profession, are better than that.As physician leaders, we bear greater responsibility within our profession and society.We must continue to put our patients before politics.

In shaping the future of health care, Dr. Barbe said the AMA is leading the way by:

By helping physicians with better preparation and better tools, they can deliver better care, Dr. Barbe said.

Taken together, he concluded, this is the way we will restore the joy to the practice of medicine.

Read more news coverage from the 2017 AMA Annual Meeting.

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New AMA president: Physicians must lead to reshape medicine - American Medical Association (blog)

Quest to spread precision medicine to oncologists nationwide … – Healthcare IT News

In April, the Office of the National Coordinator said American healthcare is at the dawn of a new age: The Precision Medicine Initiative will usher in an era of individualized healthcare, ONC chief scientist Teresa Zayas Caban and ONC health scientist administrator Kevin Chaney said.

Laboratory giant Quest Diagnostics is hopping onto precision medicine early, and with a new acquisition hopes to expand precision medicine services to community oncologists nationwide.

[Also:The dawn of precision medicine has begun, ONC says]

Quest will form what it labels a precision oncology center of excellence through its acquisition of two Texas laboratory businesses with plans to serve oncologists across the country. Quest will acquire Med Fusion and Clear Point to create a base in the southwestern United States for providing precision medicine diagnostics to aid cancer treatment and care.

The acquisition involves preferred provider relationships for Quest with Baylor Scott & White Health, McKessons The US Oncology Network, Texas Oncology, and Pathologists Bio-Medical Laboratories.

The development of standardized, evidence-based services for guiding treatment decisions within electronic health records and care plan workflows is expected to be one of the outcomes of the precision oncology center effort. Quest expects to be able to offer versions of these services, once developed, to other providers in the United States with the goal to advance better cancer outcomes, Quest said.

[Also:Widespread precision medicine is still years away, experts say]

Quest will become a preferred provider of advanced oncology diagnostics for The US Oncology Network, including Texas Oncology. The network is the largest of its kind, consisting of more than 400 locations across the United States and more than 1,400 independent, community-based physicians, Quest said. The advanced diagnostics Quest will provide include genomic and pathology testing, such as tumor sequencing, typically used by oncologists to select and monitor treatment and predict disease progression, Quest explained.

In addition, Quest will be a preferred provider of a range of inpatient and outpatient diagnostic services for 12 hospitals of Baylor Scott & White Health in North Texas. Quest will provide these services from the center of excellence site in Lewisville, Texas, upon close of the acquisition. Quest and Pathologists Bio-Medical Laboratories also will have a preferred provider relationship for several services.

Nearly 1.7 million people are expected to be diagnosed with cancer in the United States in 2017, according to the American Cancer Society.

Precision medicine is changing the way we treat cancer and giving new hope to people living with the disease, but too often advanced diagnostics that facilitate the best possible care are out of reach of community oncologists and their patients, said Steve Rusckowski, chairman, president and CEO of Quest Diagnostics. By partnering with McKesson Specialty Health and The US Oncology Network, we will make Quests state-of-the-art genomic analysis readily available to community oncologists everywhere.

The acquisition is expected to be completed in the third quarter of calendar year 2017, subject to customary closing conditions.

The center will complement Quests existing centers of excellence in San Juan Capistrano and Valencia, California; Chantilly, Virginia; and Marlborough, Massachusetts. These laboratories generally specialize in advanced diagnostic services for marquee health systems and specialty physicians. In Texas, Quest Diagnostics also operates full-service laboratories in Irving and Houston.

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Quest to spread precision medicine to oncologists nationwide ... - Healthcare IT News

Chinese Medicine is Using Donkey Skins to Boost Libidoand Africa’s Animals Are at Risk – Newsweek

Demand for a form of traditional Chinese medicine is putting the donkey population at risk in South Africa and other parts of the continent.

In recent years, the market in ejiaoa product made from boiled-down donkey skins mixed with herbs and other ingredientshas grown massively in China, putting millions of donkeys at risk of slaughter or poaching.

In South Africa, poor farmers who rely on donkeys as beasts of burden and modes of transport have reported having their animals stolen, only to later find their skinless carcasses.

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South Africas Society for the Prevention of Cruelty to Animals has confiscated more than 1,000 donkey hides en route to China in the past year, chief inspect Mpho Mokoena told Voice of America (VOA). Mokoena fears that the growing trade in donkey skins could signal the extinction of the animal in South Africa. In two years there wont be [any] donkeys in South Africa, she told VOA.

Donkey skins dry in the sun at a licensed specialized slaughterhouse in Baringo, Kenya, on February 28. The trade in donkey skins is legal in some countries, but is putting donkey populations in parts of Africa at risk. TONY KARUMBA/AFP/Getty

The slaughter of donkeys and trade in their skins is on an upward trend in other parts of Africa, too. A January report by U.K.-based charity the Donkey Sanctuary found that demand for donkeys in Africa has risen so much that, in the West African country of Burkina Faso, the cost of a single animal almost doubled from 60 ($76) in 2014 to 108 ($137) in 2016.

Read more: Take Two Herbs and Call Me in the Morning

The global donkey population stands at around 44 million, the vast majority of which are working animals, but the Donkey Sanctuary report estimated that global demand for donkey skins is between 4-10 million, with at least 1.8 million donkey skins being traded per year.

Four African countriesBurkina Faso, Mali, Niger and Senegalhave banned donkey exports, as well as Pakistan. The consumption of donkey meat is also considered haram (forbidden) in Islam, meaning that the slaughter of donkeys in many countries with large Muslim populations is frowned upon.

Donkeys are under threat largely due to the rise in popularity of ejiao, according to the report. In China, some believe that ejiao has various health benefits, from anti-aging properties to boosting sex drive, and it is even marketed as a gynecological treatment that can reduce reproductive diseases in women. Demand is so high that ejiao can sell for up to 300 ($382) per kilogram, according to the Donkey Sanctuary report.

Traditional medicine in China and other parts of East Asia is associated with the decline of other animal populations and wildlife agencies have said that wild rhinoceros could be wiped out within a decade as a result of increased poaching. Rhino horn can sell for up to $60,000 per kilogrammore valuable by weight than gold or diamondsdue to myths that it can solve a wide range of medical ailments, including cancer and hangovers.

Tiger bones are also reputed to be a remedy for arthritis in traditional medicine, while ivory from elephant tusks is also used in some medications, as well as being prized for ornamental purposes in China.

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Chinese Medicine is Using Donkey Skins to Boost Libidoand Africa's Animals Are at Risk - Newsweek