Democracy in action: D.O. Medical Excellence (DOME) Day in Austin

I joined the DO day in Austin on February 23^rd. It was my very first (somewhat) political event I attended in my life. There were 95 TCOM students, 39 DOs, and 13 others coming from across the state and outside of the state to attend the event. I admire the participation and the spirits of the students because I didn’t make the time to participate in those events as I was trying to survive in medical school.

Texas capitol is a beautiful building and most of the legislators’ offices are located underground. The capitol was crowded with a few dozen groups of different interests. It is very hard to meet the legislators because they are either in committees or meetings unless you have connections to have personal meetings. Appointments are needed to be made way in advance or made by political consultants on short notice, and the appointments are also subjected to changes.

It was a marathon day for me to have meetings with the legislative aides of 4 representatives and 2 senators. Some meetings were taken place even in the hallways outside of the legislators’ offices because there were several groups meeting already inside the offices. I was able to talk to a few TCOM students and get the pulse of the TCOM students on the issue of the UNTMD plan forward.

WSJ Letters to Editor regarding to "Where Have the Good Men Gone?

If a modern, successful woman wishes to know why men are such failures these days ("Where Have the Good Men Gone?," Review, Feb. 19), perhaps she should look in the mirror.

I'm a white male, heterosexual, Christian conservative Republican, Vietnam veteran, married 38 years with four kids. When I was young, we were supposed to get busy and stay busy, get part-time jobs, finish high school and, if qualified, go on to college and beyond. We were taught that it was our responsibility to take care of our families, which meant a wife and kids. All that began to change in the 1960s when women became "liberated" and were given equal access to what had been a man's domain. Like it or not, there are only so many jobs to go around. Given quotas, young men in the workplace no longer had an even playing field.

There are many other factors contributing to young men being overgrown post-pubescent losers: a lifetime of leftist, feminist indoctrination in the schools, a cheapening of the proper meaning of the male-female relationship and the suspension of the draft.

Miss Kay S. Hymowitz (I hate that phony term "Ms.") asks nothing of women, so let me do the job for her: When are women going to accept their God-given roles of being wives and mothers? Men and women are different; let's keep it that way. Feminists may not like my prescription, but then again, they don't like men from the get-go.

Andrew J. MacDonald, Fanwood, N.J.

Ziona Chana, a man with 39 wives, has the largest family in the world.

An Indian man from Mizoram in Kolkata, northern India has the largest family in the world with 39 wives, 94 children and 33 grandchildren, according to Malaysia Nanban.

Ziona Chana, 66, and his family live in a 100-room, four-story house set amidst the hills of Baktwang village in Mizoram.

Healthcare Reform: Civic Education Needed

The following excerpt from the book "Healthcare Solved-Real Answers, No Politics" by Debra A. Smith, DO

Office visit vs. urgent[1] vs. emergent[2] care

Health classes have failed to teach our citizens what is and is not an emergency. Too many people with urgent or emergent problems wait until their doctor’s office opens or worse yet until the office secretary gives them an appointment. Far too many people, without urgent, let alone real emergencies, go to the emergency room for care. More than once while working in the ER, a person has come in requesting a Band-Aid for a small cut on his finger, insisting that he had a right to treatment. In England, he would have been thrown out; here he will be seen. No country can afford this kind of access.

I will not attempt to go through a list of real emergencies here, but a good rule of thumb is anything that interferes with basic bodily functions, such as airway, breathing, circulation (heart beat/chest pain), for starters, or anything that causes an excessive loss of any bodily fluids from an orifice (natural or man-made), particularly the wrong bodily fluids (other than what would normally be expected), is an emergency.

While covering the emergency room at Deaconess Hospital in Cincinnati, a patient came in via squad with his family in what is referred to as agonal breathing, also known as the death rales or rattles.[3] As the name suggests, it is typical of the type of breathing that occurs close to death; the patient is not conscious of their environment at that point. I asked the patient’s wife how long he had been like this. She answered a few hours. When a person is not breathing well and is not arousable, this should immediately indicate a problem. Our people do not need to be great diagnosticians to learn the basics of what is or is not an emergency. Our schools should be teaching this. Schools should also teach students how to find a family physician, how to make an appointment, and when to use an urgent care center[4] vs. an emergency room. Too many emergency rooms have beds tied up with non-emergency care, such as sinus infections, urinary tract infections, sexually transmitted diseases. In my experience, easily two-thirds of the care is non-emergent.

Access to care and the “lack” of it

Medicine Buddha

As I left Vietnam for France when I was 12, I have learned so many gods of medicine in Greek mythology and Christ is a great healer in Christianity. Recently, I have started exploring my Buddhist roots and have found that there is a Medicine Buddha. In vietnamese, he is called Duc Phat Duoc Su.

Even though he achieved Buddhahood or Total Enlightment, which would have allowed him to enter into Nirvana, he refused to become Buddha and chose to remain a bodhisattva. The bodhisavatta state allows him to remain among us in order to answer to people's prayers. During his spiritual journey for Englightment, he made the 12 great vows if he achieved the Buddhahood.  He became the Buddha of the eastern realm of Vaidūryanirbhāsa, or "Pure Lapis Lazuli". There, he is attended to by two bodhisattvas symbolizing the sun and moon respectively: Suryaprabha and Candraprabha.

The Twelve Vows of the Medicine Buddha upon attaining Enlightenment, according to the Medicine Buddha Sutra are:

Wall Street Journal: Where Have The Good Men Gone?

Kay S. Hymowitz argues that too many men in their 20s are living in a new kind of extended adolescence

Not so long ago, the average American man in his 20s had achieved most of the milestones of adulthood: a high-school diploma, financial independence, marriage and children. Today, most men in their 20s hang out in a novel sort of limbo, a hybrid state of semi-hormonal adolescence and responsible self-reliance. This "pre-adulthood" has much to recommend it, especially for the college-educated. But it's time to state what has become obvious to legions of frustrated young women: It doesn't bring out the best in men.

Between his lack of responsibilities and an entertainment media devoted to his every pleasure, today's young man has no reason to grow up, says author Kay Hymowitz. She discusses her book, "Manning Up: How the Rise of Women Has Turned Men Into Boys." "We are sick of hooking up with guys," writes the comedian Julie Klausner, author of a touchingly funny 2010 book, "I Don't Care About Your Band: What I Learned from Indie Rockers, Trust Funders, Pornographers, Felons, Faux-Sensitive Hipsters and Other Guys I've Dated." What Ms. Klausner means by "guys" is males who are not boys or men but something in between. "Guys talk about 'Star Wars' like it's not a movie made for people half their age; a guy's idea of a perfect night is a hang around the PlayStation with his bandmates, or a trip to Vegas with his college friends.... They are more like the kids we babysat than the dads who drove us home." One female reviewer of Ms. Kausner's book wrote, "I had to stop several times while reading and think: Wait, did I date this same guy?"

For most of us, the cultural habitat of pre-adulthood no longer seems noteworthy. After all, popular culture has been crowded with pre-adults for almost two decades. Hollywood started the affair in the early 1990s with movies like "Singles," "Reality Bites," "Single White Female" and "Swingers." Television soon deepened the relationship, giving us the agreeable company of Monica, Joey, Rachel and Ross; Jerry, Elaine, George and Kramer; Carrie, Miranda, et al.

Catch Me If You Can: A Pilot has played as a cardiologist

Milwaukee, WI - A former educator and researcher at William Beaumont Hospital in Michigan has been exposed as a bogus cardiologist [1]. While there is no suggestion that William Hamman—who is a trained pilot—took care of any patients, the news that he does not hold the medical and postdoctoral degrees or have the clinical experience he claimed to have has embarrassed many cardiologists and institutions.

Hamman, who is 58, led seminars teaching cardiologists what they could learn from simulation training and from his experience as a pilot. The irony is that he could have done this job without ever claiming to have a medical degree, Dr Douglas Weaver, former American College of Cardiology (ACC) president, told Marilynn Marchione of the Associated Press (AP) yesterday: "He could have been successful without titling himself. He really didn't need to be a physician to do what he was doing. He made a very serious mistake."

Via TheHeart.org: Pilot posing as cardiologist ran training seminars

That is very impressive that he was able to fool every credentialing process, very burdensome to physicians, and claimed to be a cardiologist for some 20 years. Credentialing process for a physician to practice in a new state usually takes between 6-12 months.

Healthcare Reform: How to Be Better Patients?

The following excerpt from the Book "Healthcare Solved" by Debra A. Smith, DO

Becoming better patients

Many well meaning people have not seen a doctor in years, primarily because they do not want to be a hypochondriac like …. Fill in the blank with the name of whatever family member who nearly drove the rest of the family to madness complaining of their real or mostly imagined symptoms and illnesses.

Patients have the greatest responsibility for their own health. No one else has more to lose. This is not being a hypochondriac. Good health is so often taken for granted, until it is not there.

As an occupational medicine physician, I have done many pre-employment physicals. These exams are generally on healthy people who have been offered a job contingent on passing the physical. Most of the time, they are fairly healthy. But on occasion, I will find new-onset diabetes, hypertension, skin cancer, poor lung function (usually due to a history of smoking for more than 10 years) or any number of other problems. I tend to find most of the patients with positive findings do not have a personal physician or have not seen a doctor in years. When asked why, they generally say “I am healthy,” or “I don’t want to be a hypochondriac like…” More goofy family members have stopped patients from getting preventive check-ups and early diagnosis than any lack of health insurance.

Patients have an obligation to themselves to have a periodic preventive health examination as recommended by the US Guide to Preventive Services Task Force (USPSTF).[1]

Major Philanthropists to the Healthcare Field

Private donations key to major projects

A number of wealthy Americans have contributed to hospitals and medical research facilities in recent years.  These major gifts reduce the need for state and local taxpayer dollars to finance major capital projects, including the construction of new medical schools.  A summary of significant charitable giving (from 2009) is below.  The summaries and amounts are featured in Slate.com’s “Notable Charitable Giving in 2009.”[1]

Major donors to medical schools and medical research facilities in 2009:

9^th Largest: William P. Clements Jr.—$100 million to the University of Texas Southwestern Medical Foundation. “Clements, 92, founded Sedco, an oil and gas drilling corporation, and served two terms as governor of Texas. He pledged $100 million to the University of Texas Southwestern Medical Foundation to support the university's medical center. Clements, who placed no restrictions on how the money should be used, plans to pay the entire commitment over the next four years.”

15^th Largest: Patrick Soon-Shiong and Michel B. Chan—$65 million to Saint John's Health Center Foundation. “Dr. Soon-Shiong is a surgeon who founded Abraxis BioScience, a pharmaceutical-development company in Los Angeles. Chan is an actress. Dr. Soon-Shiong and his wife have pledged $65 million to Saint John's Health Center Foundation in Santa Monica, Calif. Of the total, the health center plans to use $55 million for research at its John Wayne Cancer Institute and to support joint research projects with other institutions. The remaining $10 million will be used to recruit physicians and scientists.  The couple previously pledged $35 million to the center in 2007. Soon-Shiong and Chan have paid a total of $45 million toward both pledges and plan to pay the remainder over the next five years, said officials at Saint John's.”

17^th Largest: Delores Jordan, who made a total of $52 million in charitable contributions in 2009, “gave $9.8 million apiece to Children's Hospital & Research Center Oakland, in California, and St. Rose Hospital, in Hayward, Calif.”

Help needed for DO students going on medical mission trip.

The O’Kanes

4780 Settles Point Road

Suwanee, GA 30024

(770) 241-2625

jacqui.okane@gmail.com

February 2011

Dear Family & Friends:

“Una alegría compartida se transforma en doble alegría; una pena compartida, en media pena “ 

Translation: “Joy shared is double joy; grief shared is half grief.” –Honduran proverb

In March I will have the honor to share in the joy and grief of the people of Tela, Honduras. Along with some of my classmates, I will be going on a medical mission trip with the Christian Medical & Dental Associations (CMDA) and Global Health Outreach (GHO) March 12-20. I am excited about the chance to reach out to our Honduran brothers and sisters living in poverty, helping to administer the physical, emotional and spiritual care that they need. Although our impact will be relatively small, we will nonetheless have the opportunity to touch the lives of the poorest of the poor.

Jacqui in Haiti in june 2010





I hope that you will join me in praying for this mission trip. Additionally, if you feel moved to donate to support the cost of my attendance, I would appreciate your financial gift. My goal is to raise at least $2,500 by mid-March. You may make your tax-deductible donation by going to www.cmda.org, then clicking on "Giving" and "Online Giving." Simply put "Jacqui O’Kane, Honduras March 2011” in the memo line so that the funds are directed to the correct place. Alternatively, you may write a check to GHO and mail it to my address, which is in the header of this letter (again, include my name and the trip details in the memo).

Thank you so much for all your love and support!

Cariñosos saludos (kind regards),

Jacqui O’Kane

The incoming spring break, about 12 DO students along with 20 other health professionals are going to Honduras to help the indigents. Please send them some love and contributions!

World Press Prize on PhotoJournalism

South African photographer Jodi Bieber won the World Press Photo Award 2010 for the portrait of a young Afghan mutilated for leaving the house of her husband. The photo of Bibi Aisha, whose nose and ears were cut off by the Taliban husband, was on the cover page of Time Magazine on August 1,2010.She was abandoned after being mutilated, the young woman had been rescued by U.S. aid, then operated in the United States.

Via Mail Online: The smile that defies the Taliban: Afghan teenager whose mutilated face shocked the world unveils her new image


Via New York Times: Portrait of Pain Ignites Debate Over Afghan War

 

A Growing Gender Gap in Doctors’ Pay: $17,000 Pay Gap

In 1999, new women doctors earned $151,600, on average, compared to $173,400 for men  – a 12.5% salary difference. In 2008, that salary difference widened by nearly 17%, with women starting out at $174,000, compared to $209,300 for men. (These are average salary figures, across all specialties).

The findings are interesting as the make up of medical students is equally the same for men and women. In some years, women's enrollment in medical schools is even higher than men.

Via Wall Street Journal: Women Doctors Face $17,000 Pay Gap

Letter to WSJ Editor: Nurse Practioner Claims Same Equivalent Competencies As Primary Care Physicians

With the nation facing a severe shortage of M.D.s, particularly in the specialties our population increasingly requires, it would be folly to cut off the quality professionals who are fulfilling primary-care needs, and who allow M.D.s to pursue the careers they are best educated for.

PAs provide, extend and support medical care in every specialty. They are essential to the medical needs of this country.

The NP work force has evolved rapidly in the past six years toward doctoral education for nurses practicing in independent primary care. Although Dr. Brown may have "sadly watched these nonphysicians take over," he should look carefully at the facts. A randomized clinical trial reported in the Journal of the American Medical Association in 2000 showed the equivalence of specially educated NPs compared with MDs in primary care. That specialized training is now incorporated in doctor of nursing practice degrees, and the graduates have, since 2008, been passing a certification exam which the National Board of Medical Examiners says measures the same competencies as physician exam takers following medical school.

These nursing graduates also bring unique competence in public health, prevention and health promotion to their patients. Years of training is a poor predictor of competence. Physicians in primary care have, on average, seven years of education and residency postcollege; doctorally prepared nurses in primary care have five years.

The underpinnings necessary for specialty medical practice are part of every physician's training, even if they never pursue those paths. For nurses, education and residency for primary care are targeted from year one, and the outcome evidence shows they are doing it right.

Prof. Mary O'Neill Mudinger

Via Wall Stree Journal: The Future Is Now for Physician Assistants and Nurses

Le Figaro: The First "Drug Baby" Umut Talha - An Ethical Challenge

It's a boy, and one imagines his parents doubly happy. The small-Umut Talha, born January 26 Antoine Beclere hospital in Clamart, is not only an infant in "good health", weighing 3.650 kg at birth. His arrival in the world should also help heal her older sister suffering from a serious illness, officials said professors René Frydman and Arnold Munnich.
As the bioethics law authorizes in France since 2004, parents of Umut-Talha ("our hope" in Turkish), whose two previous children are suffering from a blood disease, beta-thalassemia, have decided design a "drug baby" or "double hope baby." For this, they have resorted to IVF , with a dual diagnosis for preimplantation embryo retain a healthy, genetically compatible with their sick children.

Precious umbilical cord

The doctors were able to ensure that the unborn child would not have the same disease as his elders and would be a match with one of the children in care. At birth, the umbilical cord connecting Umut-Talha to his mother, rich in stem cells, was collected. These stem cells that give rise to blood cells, will be retained for a subsequent transplant to his sister.
This practice, first in France, is very rare in the world. The United States have been using a decade. It is subject in France to the agreement of the agency of biomedicine , which issues licenses on a case by case basis. According to Professor Rene Frydman, already designed the first French test-tube baby in 1982, the hospital in Clamart has a dozen couples in this therapeutic approach. Projects "that could result in the next two years," he told Le Parisien.

A process challenged

Informed citizens need to look beyond traditional media sources to get the full story.Press censorship belittles readers’ intelligence.

The pillars of the American democracy are the three branches of government: Executive, Legislative and Judicial, which ensures a separation of powers and facilitates checks and balances. Freedom of the press has been perceived as a fourth branch of the American democratic system. However, this soft power that the press has enjoyed has not had any check and balance structure to ensure that all viewpoints are heard. The press bias has become more real, and has been geared more towards sensationalism instead of true and checked reporting of facts. Partiality can never be eliminated completely because we are all human and do hold our own preferences. Fortunately, technological advancements such as the internet and social media networks have given ordinary people the ability to convey their views and voices.

Let me recount my experience dealing with the local media, the Star-Telegram and the Fort Worth Business Press. The local papers have bought into the propaganda and the figures presented in the business plan for a proposed second medical school, UNTMD, at the University of North Texas Health Science Center (UNTHSC). The Star-Telegram endorsed the UNTMD business plan without studying the feasibility and the merits of the plan:

Le Figaro: The first "drug baby" was born French

These children are conceived in the hope of a cure of their elders suffering from a rare disease. An acceptable practice since 2004.

It's a boy, and one imagines his parents doubly happy. The small-Umut Talha, born January 26 Antoine Beclere hospital in Clamart, is not only an infant in "good health", weighing 3.650 kg at birth. His arrival in the world should also allow to treat one of his older siblings suffering from a serious illness, officials said professors René Frydman and Arnold Munnich.

As the bioethics law authorizes in France since 2004, parents of Umut-Talha ("our hope" in Turkish), whose previous children are suffering from a blood disease, beta-thalassemia, have decided to design a "drug baby" or "double hope baby." For this, they have resorted to IVF , with a dual diagnosis for preimplantation embryo retain a healthy, genetically compatible with their sick children.

The doctors were able to ensure that the unborn child would not have the same disease as his elders and would be a match with the child or children to care. At birth, the umbilical cord connecting Umut-Talha to his mother, rich in stem cells, was collected. These stem cells that give rise to blood cells, will be retained for a subsequent transplant to her brother or sister.

This practice, first in France, is very rare in the world. It is subject in France to the agreement of the agency of biomedicine , which issues licenses on a case by case basis.

Via Le Figaro: Le premier 'bebe medicament" francais est ne

Necessity is the Mother of Inventions: Rats to be used to detect Tuberculosis

The animals’ sensitivity — that is, their ability to detect the presence of tuberculosis — ranged as high as 86.6 percent, and their specificity, or ability to detect the absence of the germ, was over 93 percent.

In another test that compared the rats’ success to microscopy, the rats picked up 44 percent more positive cases.

Necessity is the mother of inventions. Developping countries cannot afford expensive medical devices and have enough trained medical personel to tend care to their patients. The preliminary results of rats' performance are quite promising.

Via New York Times: Detecting Tuberculosis: No Microscopes, Just Rats

New Device Detecting Tuberculosis in lesss than 2 hours

The World Health Organization is endorsing a new tuberculosis testing apparatus that does not need trained laboratory technicians and takes less than two hours.

Cephid is a new device to make diagnosis of tuberculosis within 2 hours and does not require trained personnel to perform the task. Considering it may take up to 3 months to see if the bacterium is resistant to the most common TB drug, rifampicin. This device is only approved to be used in the third world countries as there are severe shortage of qualified professionals. If this device was approved to be used in the USA, it would have relieve the burden of long wait to see resistance to TB drugs.

Via The New York Times-Tuberculosis: World Health Organization Endorses a Device for Quicker Diagnosis

Philanthropic donations to new medical schools and centers across the nation

A number of medical school construction projects across the United States have received pledges of financial support that exceed the $25 million pledged to the proposed UNTMD campus.  These successful fundraising efforts frequently included extensive community outreach in which alumni, trustees, business and civic leaders, and community members offer major donations and sponsor challenge grant proposals designed to jump-start contributions from individuals and foundations.  The list below outlines some of the major contributions to new or expanded medical schools in recent years:

Campbell University (North Carolina)

Campbell University, a private, Baptist university in North Carolina, is spending $60 million to develop a new medical school that will open at its Buies Creek campus in 2013.  The school will use “savings, donations, loans, and other funds” to fund its project.[1]

Southeast Alabama Medical Center (Alabama)

The Southeast Alabama Medical Center is developing a private college of osteopathic medicine at the SAMC campus.  According to the SAMC Web site, the $40 development cost “includes a $15 million operating budget funded by SAMC and $25 million construction costs financed through bond sales.[2]

Marian University (Indiana)

Marian University, a Catholic, liberal arts university in central Indiana, received a $30 million pledge from an anonymous donor in support of its planned college of osteopathic medicine.  The college’s projected development cost is $75 million.[3]

University of California, San Francisco (California)

The University of California, San Francisco is planning to build a 183-bed children’s hospital that includes a pediatric emergency room and research facilities.  The children’s hospital will be part of a $1.5 billion hospital system, scheduled to open in 2014, that will also include a cancer center and a women’s hospital.   The university plans to raise $600 million through private donations.  As of June 2010, Marc Benioff, the founder of salesforce.com, and his wife Lynne pledged $100 million.  In addition, philanthropist Charles Feeney, founder of Duty Free Shoppers Group, pledged $125 million toward the project.[4]

Tet Tradition

First Morning or Head Day: is reserved for the nuclear family, that is, the husband’s household. Immediate family members get together and celebrate with the husband’s parents. A younger brother, if the parents are not alive, will visit his older sibling. Faraway sons and daughters journey to be with their parents on this day.

1. Children anticipate a ritual called Mung Tuoi, or the well wishing on the achievement of one more year to one’s life. With both arms folded in front of their chest in respect, they thank their grandparents for their birth and upbringing.

2. Reciprocally, the grandparents will impart words of advice or wisdom to their grandchildren, encouraging them to study seriously, to live in harmony with others. The promises made by the children are similar to New Year’s resolutions made during the western New Year. Adults will make silent promises to themselves to improve their lives, habits and relationships in the coming year. The children accept small gifts, usually crisp bills. Ideally, part of the gifts will be saved for future "investment," and part spent for Tet amusements. The words on the little red envelope in which the bill may be tucked read: Respectful wishes for the New Year.

3. When there was a king ruling Vietnam, the mandarins of the royal court formally wished the King and Queen, "Happiness as vast as the southern sea; longevity as lasting as the southern mountains." Each trade and professional guild in Vietnam has a founder or guardian spirit and on this or one of the next several days, the craft workers will make offerings to their guild ancestor.