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RI has highest antibiotic use in New England

November 13, 2012

And that matters to you because….?  Well, because if the bacterial infection you’re suffering from has evolved a resistance to available antibiotics, it will be harder to treat. There’s some new data about the spread of resistance, and new attention on it today.

The CDC is promoting its “Get Smart About Antibiotics Week,” and the Center for Disease Dynamics, Economics, and Policy has just updated its “ResistanceMap,” which shows where the resistance hot spots are in the U.S. and internationally.

(About the graphic: this is a smallish screenshot of the CDDEP’s state-by-state resistance data on which I’ve circled Rhode Island. Click on it for a larger view. And you can see the original here.)

Here’s some background on the problem from the CDDEP:

Scientists have been aware of antibiotic resistance since shortly after the discovery of penicillin, western medicine’s first antibiotic.  To a certain extent resistance is inevitable—as we use an antibiotic over time, resistance to the drug gradually evolves, making infections more difficult to treat and necessitating new and more powerful drugs.  However, the development of resistance is also impacted by our actions—for example by how often we prescribe and use antibiotics, and how well we control and prevent infections acquired in the hospital. In order to design sensible solutions that prolong the useful life of antibiotics, policymakers need to be able to provide factual evidence, identify trends and measure the scope of the resistance problem.


Round-up of post-election coverage on Obamacare

November 8, 2012

There have been lots of great stories in the last day or so about what President Obama’s reelection means for health care reform under the Affordable Care Act – otherwise known as Obamacare. A few of my favorites are linked below.

But what’s interesting in Rhode Island is that health care reform has been underway here for several years now, and the state has already made key decisions to comply with the ACA. Many of its other reform initiatives would probably have continued with or without federal support.  Those include things like the CSI project, an initiative out of the health insurance commissioner’s office that promotes primary care and more patient-centered care. Health reform is, in fact, near and dear to the hearts of several of our state’s top leaders. Obama’s reelection will likely mean these efforts not only move forward but move faster.  One of them: the online insurance marketplace, or exchange, which Rhode Island is calling the Health Benefits Exchange. Work on designing the exchange is well underway and a major milestone – a proposal to be submitted for federal approval – is expected soon. Not a moment too soon, either. The exchanges have to be up and running in less than a year.

Vote. It’s good for you.

November 5, 2012

Sure, it’s been a stressful few weeks – months, even. Debates, political ads, campaigning, flyers, you name it, we’re all tired of it, right? It might even be taking a toll on our mental health. And according to one study by some Israeli researchers, there’s a bit more stress in store just before you cast your vote:

Our data demonstrate that elections are exciting, yet stressful events, and it is this stress, among other factors, that elevates the cortisol levels of voters. Since elevated cortisol has been found to affect memory consolidation, impair memory retrieval and lead to risk-seeking behavior…

But overall, voting might be good for your health. There are all kinds of studies and schools of thought about empowerment and engagement in the political process, and a cursory glance at a few tells me voting is good for you, especially if you feel like you can make a difference when you cast your ballot.

More importantly, the direction of health care in America is at stake in this election. Vote one way, and the Affordable Care Act is likely to continue; vote another, it could be repealed. In Rhode Island, we may move forward with some of its key features anyway because we have some leaders in state government who are trying to make some significant changes to the way we deliver health care here. But the extent to which the federal government will support or thwart those efforts won’t be clear until after the election dust settles.

Either way, it’s up to you. You get to cast your vote for the kind of health care system you want.

And you can find out what happens on Rhode Island Public Radio! I’ll be camped out at the Biltmore downtown Providence, FYI.  And we’ll have reporters all over as well as analysts in the studio with live election coverage starting at 8 pm.

Sandy cancelled about 300 blood drives

October 30, 2012

Superstorm Sandy took out power, down trees, canceled classes and meetings and flights galore. But she also sent some unexpected disruptions. The Red Cross says the storm forced it to cancel about 300 blood drives. And it’s not sure yet what might be the long term impacts of those lost donations and power outages. Here’s what Red Cross chief medical officer Dr. Richard Benjamin said on their web site about what is known:

So far, the cancellations have resulted in a shortfall of more than 9,000 blood and platelet donations across 14 states that would otherwise be available for those needing transfusions. The situation may worsen as the storm continues to move and in its aftermath.

So, if you can, schedule a donation as soon as you can. Your never know where or when you or a loved one might need blood.

There are bound to be lots of other unexpected disruptions, health-related and otherwise. Thank goodness Rhode Island hospitals weren’t faced with the prospect of evacuating critical patients in the dark, wind, and rain like New York City’s Langone medical center. Yikes. But I can tell you that they do practice evacuations in the stairways and halls, assuming elevators aren’t working. I talked to a patient safety coordinator at Women and Infants Hospital about this once, and she told me they practiced with special sleds to whisk patients down stairs.

Mass. to consider assisted suicide

October 25, 2012

My friend Sacha Pfeiffer at WBUR filed this story for NPR about a ballot question Massachusetts voters will be asked to answer this November.  If voters approve the measure, that would make it the third state to legalize a lethal prescription for terminally ill patients who wish to end their lives.

What do you think? Would this question ever appear on a ballot in Rhode Island? Should it be put to voters? Or is it a private matter for physicians and patients? What’s more, how do doctors feel about assisted suicide? The American Medical Association’s Code of Medical Ethics says it’s incompatible with a physician’s role as healer. Please feel free to weigh in.

RI Medical Society celebrates 200 years with lecture series

October 22, 2012

UPDATE:The first lecture in this series has been rescheduled for Thursday, Nov. 1 at 5 pm.

The Rhode Island Medical Society is marking its 200th anniversary with a series of neuroscience-related lectures, all free and open to the public. The lectures are co-sponsored by Brown’s Institute for Brain Science and the Norman Prince Neurosciences Institute.

The first lecture takes place tomorrow, October 23 at 5 pm in the Friedman Auditorium at Brown University, with Patricia Churchland, a “neurophilosopher” who argues that morality has its roots in the brain’s structure and biochemistry. Next up on October 30 is the perhaps more widely recognized Steven Pinker, a Harvard psychologist who has written extensively about language, and, more recently, violence. The New York Times called him “human nature’s pathologist.”

More details about the schedule are here. Should be an engaging series.

P.S. If you’re interested in what medical school was like 200 years ago, see this recent post on Future Docs (scroll down to “a very brief…”).

How Obama and Romney differ on health care

October 19, 2012

For Rhode Islanders who are still a bit fuzzy on that or undecided about how to cast their vote, here are a couple of great resources.

  • The first is a pretty straightforward essay in the Journal of the American Medical Association by Dr. Aaron Carroll, who is based at the Children’s Health Services Research center at the Indiana University School of Medicine. It walks you through the most important differences in their philosophies.
  • The second is this video of a discussion Kaiser Health News recently convened about the impact of health care issues on this year’s campaign. KHN reporters lead the discussion with politicians and analysts.