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March 9, 2009 |
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IN THIS ISSUE
In My Opinion: Physicians Are Afraid To State The
Truth
Economist Weighs In On Stem Cell Research
Karmanos Announces Interim Leadership Team
Fourth-Year WSU Med Student Wins Trip To Annual
Meeting
Health Authority, Primary Care Association Look To
Expand Care
Dr. Lusher Earns Lifetime Achievement Award
AMA Lauds Obama's Commitment To Health Care Reform
FDA Advises Doctors On
Tainted Peanut Issue |
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In My Opinion: Physicians Are Afraid
To State The Truth
By ALLAN
DOBZYNIAK, MD
Primary care specialties have suffered more than others. Regulation
and compensation have moved rapidly in opposite directions.
Tragically, the ability to simply make a living providing primary
care is more than challenging in many locations. With this reality,
the following comments may seem harsh. But explaining the agendas
motivating the development of the Patient Centered Medical Home (PCMH)
deserves clarity. There is no shame in self advocacy, but honesty
necessitates transparency.
Requests for
information. Requests for action. Payments assured. Payments
revoked. Reward conferred. Reward withheld. Sanctions and incentives
systematically applied. This is where physicians are headed. This is
the bureaucratic nightmare designed for physicians by the financiers
of subservience.
The PCMH is a
smokescreen. It is a parade of rationalizations aimed at securing
budgetary allocations from those who cannot distinguish between
lives and budget lines; by those who actually believe the practice
of medicine can be supplanted, not supplemented, by electronic
methodology. If there were a Mohs scale for ineptitude and attitudes
of futility in proclaiming value, physicians would be at the
pinnacle. Value in this context has a deeper meaning. It is not only
defined by cost, quality and service but by lives saved and
suffering averted.
Most other
societal groups would have a visceral revulsion to the punishment
already inflicted and planned in the future for the medical
profession. They would engage more effectively than through game
theory. The game represented by The PCMH is unfortunate. The model
inflicts additional regulation as the non-physicians continue their
attempt to practice medicine. In a budget neutral environment,
attempts to divert compensation from other specialties to primary
care is a fools game. As long as the primary payer is government,
with the other insurers (if they survive) following suit, there will
never be negotiation without onerous, heavy handed, regulatory
mandates aimed at financial chicanery.
Primary care is in
the power position and can take the initiative to create change
benefiting all specialties. There is no distinction between
protecting the physician-patient relationship and the vitality of
the medical profession. The two are inseparable. To position primary
care or any other specialty for perceived victory in the
self-destructive internecine battles between specialties will result
in lost opportunity as the real war for value-driven care is lost.
This may be too
revolutionary to present, and therein lies the problem. Physicians
are afraid to state the truth.
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Economist Weighs In On
Stem Cell Research
By PAUL
NATINSKY
Wayne State University Economist Allen Goodman’s timing couldn’t
have been better. As President Barack Obama prepared last week to
sign an executive order to roll back restrictions on stem cell
research, Goodman, PhD, summarized the economic impact study he did
for supporters of Michigan’s successful ballot proposal on the issue
last fall.
Goodman’s
analysis focused on the changes that would result from a 1 percent
decrease in the cost of medical care as a benefit of stem cell
research. The percentage reduction is arbitrary – there is no proof
yet that embryonic stem cell research will result in cures or less
expensive treatments for diseases and conditions such as diabetes,
Parkinson’s disease, spinal cord injury, heart attack or stroke.
Goodman said he chose the diseases on which stem cell research is
expected to have the likeliest impact, according to established
medical researchers.
The annual cost
of treating patients suffering from those diseases and conditions is
about $8 billion, according to Goodman’s analysis. A 1 percent
savings would reduce Michigan’s health care cost burden by about $80
million.
Goodman likened
his “impact analysis” to the effect of a “dry” county that sells no
alcoholic beverages converting into one that does. Changes to the
economy, including increased liquor sales, new restaurants bars and
liquor stores would exist side-by-side with the possibility of
increased traffic accidents and family problems. Impacts could be
both positive and negative.
The more tangible
side of Goodman’s presentation centered on job creation,
specifically in biotechnology. He estimated the creation of 443
direct jobs and another 354 “induced,” or support jobs not directly
related to biotech positions. Goodman estimates the total payroll
for these 797 jobs to be about $51 million per year.
For perspective,
Michigan’s state government will spend about $44 billion this fiscal
year; so the impact is not like opening a few new manufacturing
facilities or relocating a major company’s world headquarters to
Michigan. Goodman did factor productivity gains from less worker
absenteeism and fewer premature deaths, and wound up with total
gains of almost $28 million a year from those two categories. He
avoided considering potential money from royalties and patents,
arguing that such numbers were too murky (some other states have
included them). Ultimately, the total economic impact he predicted
was less than $200 million per year.
Goodman did not
place a dollar value on the quality-of-life improvement to those
whose lives potentially are improved by the research, nor a value on
the “well-being of loved ones.”
While the
advertising campaign in support of Proposal 2, presented a strong
emphasis on economic benefits to Michigan in its advertisements,
Goodman said the potential economic boost for Michigan was always a
secondary concern to finding ways to improve quality of life for
patients.
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Karmanos Announces
Interim Leadership Team
The Barbara Ann
Karmanos Cancer Institute and Karmanos Cancer Center boards of
directors announced that effective March 5, Ann G. Schwartz, PhD.,
has been appointed interim president and chief executive officer,
and Paul Broughton has been appointed interim chief operating
officer.
“Dr. Schwartz is
an excellent choice to lead us during this period of transition,”
said Alan S. Schwartz, chairman of the Karmanos Cancer Institute
Board of Directors. “As interim president and chief executive
officer, Ann will focus on leading the institute’s scientific
direction, while continuing our outstanding world-class research in
basic, clinical and population sciences.”
Having rejoined
the Karmanos faculty 10 years ago, Dr. Schwartz, who is unrelated to
Alan Schwartz, has extensive experience and knowledge of the
institute.
Previous to this
appointment, Dr. Schwartz served as the associate center director
for Population Sciences at Karmanos since 2002. Her research focuses
on the genetics underlying lung cancer risk. She has a master’s
degree in biology from Wayne State University, a master’s in Pulbic
Health in Environmental Health from the University of Michigan and a
doctorate degree in epidemiology from the University of Michigan
School of Public Health.
As interim chief
operating officer, Broughton’s main responsibilities include the
smooth and efficient operation of the Karmanos Cancer Center to
ensure the delivery of high quality care at the hospital and all of
the Karmanos clinical operations while continuing their
profitability.
Broughton served
on both Karmanos boards through December 2007 and was a member of
the institute’s Finance and Compensation committees. Prior to his
retirement, he was president and chief executive officer of Harper
Hospital and Children’s Hospital of Michigan.
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Fourth-Year WSU Med
Student Wins Trip To Annual Meeting
Alexandria
Conley, a fourth-year student at the Wayne State University School
of Medicine, has received the sanofi-aventis Minority Scholars Award
from the American Academy of Neurology Foundation.
Conley, 27,
will receive a travel stipend to attend the AAN annual meeting in
Seattle, Wash., April 25 through May 2, paid registration for the
meeting and will be able to register for educational programs at the
junior member rate. She will receive a certificate of recognition
and be acknowledged during the AAN and AANF awards luncheon.
“Attending the
AAN meeting is an honor for me,” said Conley, of Detroit. “I am
grateful that the sponsors have created an opportunity to increase
diversity in the neurosciences, and I feel very privileged to have
won this award.
“The theme of
this year's AAN meeting is ‘Better practices, better outcomes,’ an
important concept that I believe applies to physicians across all
disciplines,” she added. “However, I am particularly excited to
learn more about the research and clinical work that is being done
to help improve prognosis and quality of life for patients suffering
from neurological disease.”
William M.
Coplin, MD, an associate professor of Neurology & Neurological
Surgery for the School of Medicine, and chief of Neurology and
medical director of Neurotrauma & Critical Care for Detroit
Receiving Hospital, nominated Conley for the award. Conley worked
with Dr. Coplin during her fourth-year neurocritical care/neuro-trauma
elective.
Conley serves
as a class representative on the Student Senate, is a member of the
Aesculapians service honor society, the Gold Humanism Honor Society
and the Black Medical Association/Student National Medical
Association. She also is a member of the American Medical
Association, the American College of Physicians and the World Health
Student Organization.
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Health Authority, Primary Care
Association Look To Expand Care
A study,
undertaken through the Primary Care Network Council by the Michigan
Primary Care Association and Detroit Wayne County Health Authority,
has identified 12 areas of high need for new or expanded health care
services in Detroit . The study recommends six priority areas for
considering establishment of new primary care facilities, and it
recommends the expansion of existing health care facilities and
services in an additional six priority areas. The Council's Safety
Net Expansion Committee also identified eight additional areas in
the Greater Detroit Wayne County area that it recommended for
consideration as possible locations for new health care facilities.
The Council's
Safety Net Expansion Work Group, chaired by Wayne Bradley, CEO of
Detroit Community Health Connection, established four principles
that will guide implementation of the expansion/establishment of
facilities:
Establish the
Primary Care Network Council as a forum for encouragement and
support of expanded Federally Qualified Health Center (FQHCs)
services, specifically encouraging the cooperation of existing FQHCs.
Identify and
prioritize geographic areas on the basis of need for new or expanded
health care services.
Adopt a
multi-faceted strategy for primary health care safety net expansion
Encourage any
organization seeking to expand access to quality health care as long
as the propose expansion will not result in a diminution of services
to the underserved.
For more
information, contact Joslyn Pettway at 313-871-3751 or jpettway@dwcha.org.
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Dr. Lusher Earns
Lifetime Achievement Award
Jeanne M. Lusher, MD, Distinguished Professor of Pediatrics and the
Marion I. Barnhart Chair of Hemostasis Research for the Wayne State
University School of Medicine, will receive the Lifetime Achievement
Award from the Hemophilia & Thrombosis Research Society.
Dr.
Lusher, who also serves as co-director of the Division of
Hematology/Oncology and medical director of the Special Coagulation
Laboratory of Children’s Hospital of Michigan, will accept the award
at the society’s annual meeting April 17 in Chicago.
“I
feel very honored to be receiving the society’s major award, which
has been awarded only three times before,” Dr. Lusher said.
Her
major field of work is in hemostasis -- clinical, laboratory
methodology and clinical research -- with particular interest in
Factor (F) FVIII and FIX inhibitors in hemophilia. She has written
numerous scientific articles concerning inhibitors, their antibody
nature, detection, kinetics, etiology, natural history and
management. She has also written articles covering variations in
FVIII assay results depending on reagents and standards used, and on
the unique properties of FIX inhibitors in people with Hemophilia B
(FIX deficiency).
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AMA Lauds Obama's
Commitment To Health Care Reform
The AMA issued
the following statement attributable to President Nancy Nielsen, MD,
in reaction to President Obama’s recent speech:
“America’s
patients and physicians want meaningful progress on health system
reform this year, and the American Medical Association applauds
President Obama’s commitment to achieving that goal.
“In these
tough economic times, the need for health system reform that
provides coverage and high quality, affordable health care for all
Americans has never been more clear. We must strengthen the
public-private mix of health insurance, and achieve greater value
from the nation’s health care spending. President Obama’s call for
greater investments in research, preventive care and electronic
health records will help physicians keep patients healthy.
“We pledge
to work with President Obama and Congress to improve the health care
system for all Americans.”
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FDA Advises Doctors
On Tainted Peanut Issue
The Food and Drug
Administration (FDA) is asking physicians to remind patients who
have bought peanut-containing products that are on the federal
recall list to discard those products in a manner that prevents
others from eating them. So far the federal government has announced
recalls covering hundreds of peanut-containing products related to
an outbreak of salmonella in states across the country.
Physicians can
point their patients to
http://www.accessdata.fda.gov/scripts/peanutbutterrecall/index.cfm
for details from the FDA about the recalls, including a list of
recalled products.
Some pet foods
and pet treats may contain contaminated peanut butter, including dog
biscuits and bird food. The Centers for Disease Control & Prevention
(CDC) has developed a fact sheet to inform people how this outbreak
might affect their pets.
Visit
http://www.cdc.gov/salmonella/typhimurium/salmonella_pets.html
to view the CDC Web site.
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