Past Issues
Pathways Through Medicine: Healthcare Outreach in Ethnic Communities
Diagnosing and treating ethnic communities is no easy task. In order to effectively treat diseases, physicians and community outreach workers must navigate the complex web of details created by factors such as the languages, cultures, and the specific, relevant details of the diseases. Programs for treating hepatitis B and asthma within the Asian and Pacific Islander (API) communities of large cities illustrate important approaches and common difficulties in treating ethnic communities.
Educating Innovators
Throughout history, innovation has been an integral–if less emphasized–element of the physician’s job description. Many great medical advances like asepsis and anaesthesia were in fact pioneered by doctors. Today, though, the environment in which they must innovate has been greatly transformed by both the rapid specialization of scientific research and regulations from agencies like the FDA. As a result, a handful of academic medical centers have taken the lead in educating future physician-innovators, offering focused curricula that forge stronger cross-institutional connections with the medical device industry.
Healthcare Gone Digital
Dr. Ming Shing Chiu finds it difficult to balance his personal relationship with his patients and the increasing burdens of HMO rules, especially now with electronic recordkeeping. Though electronic records ultimately benefit the patient, Dr. Chiu explores an unintended side effect which future doctors would be prudent to be wary of.
Religion, Conscience, and Controversial Clinical Practices – An NEJM Special Article
Curlin et al., NEJM, February 8 2007, Vol 356 (6)
Despite being legal, many medical procedures may be personally objectionable to certain health professionals. In addition, would physicians refer patients to another professional willing to perform the requested procedure? Do they feel obligated to present all options? While the answer remains unclear as to whether physicians are obligated provide these treatments, a survey done by the authors sheds light on the attitudes and practices of physicians towards controversial medical procedures.
Medicaid Revisited – An NEJM Health Policy Report
Iglehart, NEJM, February 15 2007, Vol 356 (7)
Fluctuating with the economy, Medicaid has once again landed itself under scrutiny. Federal spending alone for Medicaid is projected to total about $2.8 trillion over the next eight years. Such daunting numbers have prompted the creation of the Deficit Reduction Act, which aims to slash federal expenditures on Medicaid by $26.4 billion in the next decade. Even prior to the approval of the act, payments have been consistently reduced–and have been impacting the willingness of physicians in accepting new Medicaid patients.
Extensively Drug Resistant Tuberculosis – An NEJM Perspectives Article
Raviglione and Smith, NEJM, February 15 2007, Vol 356 (7)
Beyond the existence of multidrug-resistant tuberculosis, the most resilient strain of tuberculosis, extensively drug-resistant (XDR) tuberculosis, is increasingly making its presence known. The misuse of second-line drugs has fueled a global health problem whose solution-new classes of anti-tuberculosis drugs-may not appear for at least several more years. In light of this dearth of tools against XDR tuberculosis, what are clinicians to do?
Pathways Through Medicine: The MD/PhD
Historically separated by a philosophical and intellectual rift, clinical practice finally marries scientific research in the physicians who also pursue Ph.D. training. With the explosion of discoveries in the natural sciences in the past few decades came a tremendous opportunity for translational research on human disease. MD/PhD programs across the country cater to students fascinated by both medicine and research and train physician-scientists prepared to bridge the gap between the lab and the clinic. While the lengthy education offers certain disadvantages and the dual-sided career is difficult to balance, many physician-researchers find their careers intensely rewarding.
Pathways Through Medicine: Allergy and Immunology
Dealing with one of the most complicated systems in the human body, the immune system, the field of Allergy and Immunology has some added challenges. Physicians and physician scientists from the University of Colorado Health Science Center and the National Jewish Medical Research Center share their experience in residency, in research, and ultimately in a career dedicated to expanding and applying our understanding of immunology, such as with inflammation, innate immunity, pharmacogenetics and disease heterogeneity.
Current Concepts: The Asthma Epidemic – An NEJM Review Article
W. Eder et al., NEJM, November 23 2006, Vol 355 (21)
Asthma prevalence and incidence is rising in both the Western world and the developing countries. The complexity of the illness has continued to call for further understanding in the diverse determinants of its onset. And while no single test can be used to identify asthma with full certainty, Dr. Waltaud Eder and colleagues summarized two standards for diagnosis, and describes several factors that could impact the condition in patients.
The Ethics and Politics of Compulsory HPV Vaccination – An NEJM Perspectives Article
J. Colgrove, NEJM, December 7 2006, Vol 355 (23)
With the approval of the Food and Drug Administration’s licensing of a vaccine against human papillomavirus (HPV), lawmakers are starting to consider legislation that would make the vaccination a requirement for girls entering sixth grade. While certain advocacy groups have vehemently opposed this new possibility, seeing the vaccine as yet another issue to polarize the debate of “science vs. religion,” others see other perspectives in framing the debate.
