There is a very interesting blog post over at Friday Puppy, a blog run by an openly gay local business owner about having his blood donation being denied due to the fact that he has relationships with other men. The article is sharp and opinionated, but the points are fleshed out into logical arguments in the comments section below. I think the post brings up some very interesting points. Perhaps it is time for the FDA to update their screening questions. Check it out here.
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Categories : Pathology, Politics
I’m not sure if this kind of mandate has been rolled out across the country, but here in New York, we were told, up front, that the entire hospital staff was required to get a flu shot this year (and the swine flu shot as well when it comes out) OR face termination. Fired over a flu shot? I thought Cleveland Clinic’s anti-smoking policy was pushing it…
There have already been talks of protests and law suits here in Albany. Personally, I’m indifferent, but I guess I can see their point- being forced into doing something they otherwise would not have done, but is it worth a law suit? Probably not.
I’ve heard a few different explanations for dissent. Perhaps the most interesting reasoning I’ve heard is this- because the flu shot is offered for free or reduced cost by the drug companies, the companies are protected from litigation if a patient is injured as a direct result of the vaccination. Another question to be asked would be, “Does the punishment fit the crime?” Is termination the proper penalty for not receiving a shot? They require house staff to be up to date on their vaccinations, after all. So is that any different? I suppose. Can you fire an employee for poor hygiene? Either of my examples could perceivably place patients at risk, but it’s not clear to me that either of these would be enforced. Finally, do ALL employees really need the shot, even those with no patient contact? As a pathologist, I did ask myself that question. Sure we have some patient contact, and we surely have contact with other employees that do have contact with patients, so I suppose the idea is to cover all your bases and just vaccinate everyone.
In the end, it seems clear to me that the New York State government has gotten swept up in the media craze surrounding the H1N1 virus, which, as a concept is sad, but in practice is probably better for everyone in the long run. I do wonder, however, if we will be required to get our flu shots next year too… 😉
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Tags: H1N1, new york, vaccination
Categories : Medicine, Opinion, Politics
Below is a link to the mp3 of an interview with Albany Medical Center’s CEO Jim Barba in which he defends Obama’s Public Option proposal. The interview originally aired on Siena College’s WVCR Radio Station.
I thought it was a very interesting perspective, and is yet another health professional coming out in support of the public option. Interesting!
He goes on to talk about the viability of a single-payer system as well (waters far too murky for me).
I guess when I’ve thought about health care reform, I had never really imagined that the CEO of a hospital would support a single-payer system… A public option? Sure, but not single payer. He does make an interesting argument, however.
Definitely worth a listen!
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Tags: Albany, amc, Barba, Jim, Medical Center, Option, Public
Categories : Medicine, Opinion, Politics
Did you know that James Macri owns ß-hCG? Did you know that someone could even own such a thing? Well, according to US Patent 5,252,489 he does. More specifically, Dr. Macri owns a patent covering the use of the free beta subunit of hCG in Down syndrome screening, amongst many others.
I have always assumed that any machine used in the lab or any paricular physical material used in our daily operations was invented and patented by someone at some point, but I suppose I had never thought that a test, or a technique could be patented as well (naive resident, folks).
I suppose it makes sense when you think about it. If someone develops a novel way to do something, it seems right that that person be able to patent that activity so he/she be rewarded for their work, and should not have to worry about another party scooping up that work and profiting from it without putting in the time and effort to develop it.
At the same time, there comes a point where something is so generic or so integral to basic function, that it can’t (or at least shouldn’t be able to) be patented. I know because I tried to patent ‘Lungs’ as ‘an organ used to exchange atmospheric oxygen across a thin cell layer’ and they rejected my claim.
So, I suppose, the point of discussion is, at what point does something become so integral or generic that it is not patent-able? You couldn’t patent ‘looking through a microscope at H&E slides to arrive at a diagnosis’ (at least now, anyway (see above image, lol)), but you could certainly patent ‘looking through a microscope at fluorescent labeled antibodies for translocations to arrive at a diagnosis’. Both are exceedingly vague, but it seems to me that by adding fluorescence to the equation, it grants just enough specificity and contemporary relevance to the process which therefore makes it patent-able, and I am not sure how I feel about that prospect…
On the one hand, patent law was clearly established to spur innovation and protect the inventor’s ideas; that seems obvious and just. Alternatively, innovation could be, and is stifled by restrictive legislation preventing the use and application of certain inventions on a daily basis. Given: every established system of laws can be and is bent or abused to some degree, but we, as a society, need to realize when enough is enough.
Some examples of this flagrant abuse can be seen on ‘The Culture of Ownership‘ blog run by Mrs. Molly Wood. Some recent post include ‘Monster Cable’ suing ‘Monster Mini Golf‘ and ‘Monster Transmission‘ for trademark infringement, as if anyone would confuse over-priced cabling for some place you go on a first date or a means to transport your hot rod from Charlotte to Tucson. Most recently, an injunction has been filed by i4i against Microsoft, preventing the sale of Microsoft Word, claiming the XML formatting in Office 2007 is proprietary and was not licensed for use. Certainly, Microsoft, in this last example could be guilty of stealing technology or ideas from this smaller company, but as it turns out, the i4i has no product to show for itself containing the technology in question. This last example also demonstrates the concept of ‘patent squatting’ in which someone files a patent for an idea that they either do not know how to move to fruition or do not have the means to do so. “[T]he rights granted by the government do not guarantee that inventors will be able to make, use, or sell the invention. They can merely prevent others from doing so.” (Haddow, 2009). I *thought* that patents would not be granted to people who had no means of ever producing a meaningful expression of a the contents of their patent, but, clearly, in practice, this does not appear to be the case.
Finally, I have read about instances where companies buy up competing patents in an effort to stiffle competition. A hypothetical example of this would be if, say, an oil company bought the rights to a type of electric car technology and basically hid the patent on a shelf somewhere, thereby prohibiting the construction of said electric car which would conceivable compete with it in the marketplace. Is this fair capitalism, or is this abuse? I suppose the argument could be made either way; I’ll let you decide on which side is ethical or legal.
Now imagine if this disease were spread to medicine or to Pathology specifically. I feel that it is probably a fair assumption that some or all of these shady practices are, in fact, in play in the field of lab medicine; I guess that, before today, I hadn’t realized exactly to what extent.
Now, with a piqued interest, I will be keeping an eye out for the dissemination of the culture of ownership within medicine and within pathology and I will remind everyone- ‘everything in moderation’.
Haddow J. Patents in Prenatal Screening. Presentation. April 2009.
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Tags: Culture of Ownership, Patent Law, Patents
Categories : Informatics, Medicine, Opinion, Pathology, Politics
CNet.com’s Podcast Buzz Out Loud, a podcast near and dear to my heart, will have on their show today (1pm ET, 11am PT), Aneesh Chopra, the newly appointed United States ‘CTO’. He has embarked on his first tour of Silicon Valley and will be stopping by a few venues for interviews this week.
The podcast hosts put out a call to the community for questions for the distinguished gentleman; if you’d like to post your own questions, the thread can be found here:
I specifically asked about the EMR initiative so highly touted by President Obama- what are the plans, nationalized/government run vs private, protection of physician privledge while maintaining portability and access, etc; hopefully they will pick my questions 😉
To catch this video podcast live, check out http://www.cnet.com/live at 1pm ET today.
UPDATE: Below is the video of the interview. They did in fact ask my question(s) (my question is read at the 10:00 mark), and Mr. Chopra’s response was cordial if not a little round-a-bout, but interesting and welcomed nonetheless. It was an amazing opportunity to get and an honor to be chosen. Thank you to C|Net and to Mr. Chopra.
Vodpod videos no longer available.
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Tags: Aneesh, BOL, Chopra, EMR, Health Care
Categories : Informatics, Medicine, Politics, Uncategorized
He first references an article published by the AMA about this topic:
“Medical students who went into debt could figure on owing $126,714 in 2007 on average, up from $88,331 in 2000, according to the Association of American Medical Colleges… Suggestions under consideration would take approval by powers greater than the AMA. They include providing tax deductibility for tuition and loans, and expanding state and federal scholarship opportunities. But another cost-cutting approach is investigating ways to reduce the length of medical schooling—perhaps through competency-based curriculums, or through combined B.A./M.D. programs.”
The article also goes on to say that 23% of medical students graduate with over $200,000 in debt (let’s not forget that you have to go to college first!). In fact, my personal educational loan grand total was greater than $250,000 when I graduated, and after two years of interest, I’m almost afraid to see where it is now.
Dr. Friedman then goes on to offer his suggestions as to a solution:
- “Medical schools should begin to accept students, as in former years, after three years if they have fulfilled all of their undergraduate course requirements. If this is impossible given the number of such prerequisites, this number should be reduced such that it is possible for most applicants to quality for the new program.
- On a selective basis, medical school should allow some students to skip their fourth year and graduate in three. This should only be an option for the most mature students who have amply demonstrated their ability to function well as they pursue their post-graduate medical training. “
My response is as follows:
As a graduate from a combined college/med school program myself, I feel like I have some insight to share on this. Where I went to med school they had 3 combined programs, mine was 8 years, and there was a 7-year and a 6-year program as well. IMHO, those ‘kids’ who had only 2 years of college, while they may have been very bright, some of them were wayyyyy to immature for medicine (one of them had a breakdown, actually, and dropped out). Having said that, however, to pick medical students worthy of graduating early based on their ‘maturity’ is vague and subjective, and, I think, ultimately not fair.
The issue of debt from education is undeniable, and GP is suffering as a result, for sure. And, while I think cutting years is a clever approach, I just don’t think it’s the answer. Personally, I think the direct approach is the best here. Can ANYONE explain to me why med school was $55,000 a year for me? Sure people always say, “Well, you’ll be good for it in 8 years” or whatever, but that’s really not ok. My medical school was one building, with quite a finite list of teachers and services, yet it cost twice as much as college and didn’t come with room OR board! During my tenure as a medical student, we actually approached our dean about the outrageousness of the tuition (I think we were 3rd in the country for most expensive medical school at the time), and the fact that the tuition was continuing to go up almost yearly. Well, he sat our whole class down and showed us a 100-foot pie chart of our expenses. And with that, we had our answer. Now, I’m not 100% sure I’m recalling this EXACTLY, but if memory serves me: about 30% of our tuition went to float the hospital’s pro-bono work. Is this true elsewhere? I was outraged, we all were. Absolutely, these people need to be cared for, but to place the burden of the medical students’ shoulders is grossly inappropriate. In addition to this, we also had to pay a multi-thousand dollar ‘national security fee’ or something of like. Unreal. In the end we all just sucked it up, but it’s not ok. Things need to be fixed or the system will collapse in on itself.
Nobody likes people that complain and then don’t offer an alternative, so here are my ideas:
- My medical school is as expensive as it is because we have one of the WORST endowments in the country. There should be more focus on giving back, in the form of alumni office activity, and also, you attendings out there should do your parts!!
- If I decide to go to med school, I should be paying for my education and not ER work for the uninsured. I suppose this could be fixed by adopting a nationalized health care system, but I’m not about to open that can of worms. Again, I’m not sure if this situation is recapitulated elsewhere in the country, but there must be some shenanigans to justify $55,000 a year.
- Go to a state school or live in a country outside the US. LOL. But seriously, many of my co-residents have ZERO debt because medical school is paid for by the government in their country. Programs similar to this DO exist in the United States. First of all, there are the Armed Forces. Also, there are various programs (most of them in Family Practice, I believe) that will pay for medical school with a X-year contract to practice in underserved areas. I think these could be some valid alternatives to signing away your soul to some people.
Now, I realize that #3 is a band-aid and not a cure. But, IMHO, the key is to cutting costs by forcing accountability for tuition fee composition. Also, I think the AMA is on the right track with tax write-offs and subsidies as well. I’m not saying medical school should be free (as I think in the end, most of us are successful enough to pay our loans back so we shouldn’t have to burden the country with our educational expenses), but it should be affordable enough that what happens with my graduating class does not continue to happen across the country- we had four people (out of about 120) go on to pursue residencies in Family Medicine. Four. And that is just not sustainable.
Some food for thought.
What do you think? 🙂
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Tags: Debt, Loans, Medical School
Categories : Medicine, Politics