Public Health

Panic and Preparation

Things move fast in an outbreak – whether an outbreak of disease, panic, or both. A lot has happened since my last blog post. I wrote the last post just after Thomas Duncan became the first person to die of Ebola on U.S. soil, and nurse Nina Pham was infected while caring for him. In the past month, we have seen one additional nurse infected with Ebola, and both Amber Vinson and Ms. Pham have been discharged from the hospitals after clearing their infection. Some have cheered and others jeered as nurse Kaci Hickox has clashed with the governor of Maine over an imposed quarantine after she returned from Sierra Leone.  The number of cases has also crossed the 10,000 mark, with many more to come. Discussions continue about many facets of the outbreak: Where were mistakes made? How should we prevent the spread to healthcare workers? How should we…

Ebola and “Unknown Unknowns”

I did not think I would ever quote Donald Rumsfeld in one of my blog posts, but some of the missed opportunities as well as the media and public panic surrounding the Ebola epidemic in West Africa have brought this quote to the forefront of my mind this past week. First, let me share my personal view of the Ebola crisis in West Africa. It is a tragedy in all senses of the word for Guinea, Liberia, and Sierra Leone. As a wealthy country and as global citizens we have a moral obligation to assist in the control of this outbreak and to help these countries build/rebuild their health and economic infrastructure after the devastation wrought by this disease. If the moral argument does not do it for you, remember that we have self-interest here, too. We benefit domestically from increased control of the disease in Africa and fewer cases…

Q: How do you call a pharmacist? A: “Waiter!”

  That was the old cardiology joke from a decade ago when job supply exceeded demand.  The field seemed to get its groove back—through both supplier-induced and demand factors—but do not hold your breath.  Workforce needs have only begun to get critical reappraisal and I would not rule out restaurant service for any specialty as health reform shakes out our sector. Along those lines, as medicine becomes a team sport, ratios of doctors to nurses, PA's, NP's, therapists, and pharmacists all will undergo scrutiny.  And as of 2014, I thought I had a handle on where things stood.  As to pharmacists at least, I read the wrong playbook.  I had no idea: Now, the profession is on the verge of a crisis: The number of pharmacy jobs has dried up but the number of pharmacy students keeps growing. It’s difficult to find a cushy, full-time job and metropolitan job markets…

“Why I Hope to Die at 75”

  Zeke Emanuel, well known oncologist, policy wonk, and eldest brother of Rahm (Mayor of Chicago) and Ari (Hollywood powerbroker), always has a way of garnering attention. Published in the latest The Atlantic, Zeke pens a very provocative piece on when he plans on calling it a day.  In his case, age 75.   (more…)

Disillusioned

I don't know if anyone had a chance to hear the interview on Fresh Air on NPR with Dr. Sandeep Jauhar about his recent book,  Doctored: The Disillusionment of an American Physician. I found that I could easily relate to his perspectives on modern medicine. He discussed how patients increasingly are living with multiple chronic illnesses that require multiple sub-specialists; but that there is little time for coordination of that care, much less preventative care in an environment that wants primary care physicians to see patients every 10 minutes. [caption id="attachment_11046" align="alignleft" width="200"] source: www.amazon.com[/caption] Dr. Jauhar talked about how, though physicians know there is a great need for primary care physicians, the payer model doesn't support a system that forces physicians to see patients on the basis of volume, with less pay.  That specialists who just "see patients" are not nearly as profitable as  those who perform diagnostic tests,…
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