Tuesday, November 29, 2011

In the Face of Failure

Alas, the congressional supercommittee failed to reach a concensus regarding deficit reduction -- so Medicare payments, GME funding, and many other medical and public health programs will be automatically cut as of 2013. Advocates are worried that the cuts will affect biomedical research (especially NIH funding), CDC funding (including emergency responses and subsidized vaccines), andHIV/AIDS therapy for low-income patients, to name a few.

The AMA is especially concerned about the new Medicare cuts, given that there is already a 27% payment cut scheduled for Jan 1 of next year. AMA Pres Peter Carmel said, “Congress has ignored the reality that short-term patches have grown the problem immensely. The cost of repealing the formula has grown 525 percent in the past five years and will double again in the next five years.”

In other federal government news, CMS Director Donald Berwicke is out, Deputy Administrator Marilyn Tavenner is in. Berwicke was appointed to the position in 2010 without congressional confirmation, with Republicans wary of his "pro-health care rationing" stance. Tavenner is similarly unlikely to be confirmed -- apparently no CMS director has been since 2009 -- and instability within the agency is likely to remain unchanged. The AMA supports Tavenner, though, if that helps things.

With so much going on in the world of health care this week, you can't help but get riled up. If you want to use this passion to get more involved with the AMA, the national Standing Committees are again accepting applications through Thurs 12/1! A bunch of us from your UB AMA hold positions on various committees, so feel free to e-mail us at sunybuffaloama@gmail.com with any questions.

Saturday, November 12, 2011

The News from New Orleans

Right now, your delegation from SUNY Buffalo is sitting in the main ballroom at the New Orleans Sheraton for the Interim AMA meeting. Dr. Peter Carmel, the current president of the AMA, is encouraging -- nay, URGING -- all medical students to call the following number:

1 (800) 833-6354

It's a telephone service that links you to leave a voice message for your congress person to tell him/her that IT IS ESSENTIAL TO INCREASE THE GRADUATE MEDICAL EDUCATION CAP NOW. (That's literally all you have to say. Say this, maybe your name, and hang up. Easier than Med & Society.)

Otherwise we won't have jobs when we graduate. Well, some second years will. But the first years won't.

So take two minutes out of your studying, or during a commercial of whatever your sporting event of choice is, and call that number. Because, in the words of someone much wiser than I, it is essential to increase the graduate medical education cap now.

Wednesday, November 9, 2011

Hi welcome to Walmart, the Doctor/NP/PA will be seeing you shortly!

I will admit I am an NPR slave. I listen to it every morning on the days I decide to come into class-today is not one of those the days. So every time I read or hear a story about medicine or healthcare reform I am especially attentive. Today I read this article:


What this article discusses is retail behemoth Wal-Mart's potential foray into providing primary care clinics in its stores. When I first saw this I immediately laughed. Of course Wal-Mart is trying to take over the world, this is just one more step in their global domination plan. They already have pharmacies, grocery stores (in their super Wal-Marts) as well as auto shops all under the same giant roof. In fact the optometrist I go to see is a Wal-Mart optometrist. So this is a logical next step. I guess I can't be too skeptical because Wal-Mart as a business rarely makes bad business decisions (I say business decisions because cutting the insurance policies of part time workers isn't the most ethical of decisions)

The portion of this story that may be especially relevant to medical students is the current plan has these future clinics being staffed primarily with nurse practitioners and physicians assistants. Lately there has been a great deal of controversy over the title of doctor and the roles of NPs and PAs. Could Wal-Mart clinics be a game changer that effects the way medicine is provided? The author of the article doesn't seem to think so, but then again this is Wal-Mart were talking about.

Thursday, November 3, 2011

With Great Power Comes Great Responsibility

There's a lot going on this week. And I'm not even talking about the First Years' anatomy exam. So please, bear with me, and at least skim through to the end.

First: Residencies. More medical schools + expanding medical school classes + proposed decrease in funding for graduate medical education = Not good for any of us. Do your future MD-self a favor, and go to this website to urge your congressperson to protect GME funding. All you have to do is type your name, address (it's a secured AAMC site) and click submit. If you're feeling more intrepid, check out the unofficial MSSNY-MSS website "The.Hidden.Curriculum," which is featuring a post on misconceptions about residency. It's worth a read.

Second: This part is going to get a little angry. (Feel free to skim, but it might be fun to experience my ire.) If you've read the more commentary-ful blogs on here before, or if you've met me, or if you decide to stereotype my values by my community health background and health care worker designation (correctly so, by the way), you'd know that I really, really hate anti-vaccine propaganda. I understand that that one MMR-autism article was rescinded by the author -- but how much of the general population does? Once information is out there -- especially information that broadcasts child illness -- it cannot and does not go away. I was just peering through Facebook, as I am wont to do, and saw an AMA-MSS update ("Like" their page here) that Delta Airlines is running anti-vaccine commercials during their in-flight entertainment. It's sponsored by the National Vaccine Information Center, whose website at publication discusses Vaccine Awareness Week. KevinMD's blog posted a great reaction to this and other anti-flu shot slander -- recognizing that everything has the potential for adverse effects, but the benefits far, far outweigh the risks. Especially when the risks are so infrequent.

Which brings me back to UB. This week, UB is running free flu clinics for all affiliated students and staff. That means that YOU should get your flu shot tomorrow in the BEB atrium between 9 am and 3 pm (your anatomy exam does not extend that entire time). Unless you have medical reasons to abstain from the vaccine, I can't imagine a good reason you can have. As a medical student (target demo here), you have a responsibility to your patients to NOT GET THEM SICK and to yourself to NOT GET SICK. Imagine getting the flu three days before the NEXT anatomy exam. Or going into preceptor in January feeling a little under the weather, and taking a history from an older patient undergoing chemotherapy. The MMWRs for the last forever have shown that flu season peaks around Valentine's Day. Not December, and not January. Lots of opportunities to get sick. Get your shot now.

Also, if you've made it this far, really go to the AAMC site to urge your congressperson to protect GME funding. Otherwise, your future MD-self may be unemployed. And that guilt is far more powerful than mine convincing you to get a flu shot.