Medical Association – Civilav Med Mon, 21 Nov 2022 19:34:44 +0000 en-US hourly 1 Medical Association – Civilav Med 32 32 Clogged hospitals trigger warnings from Minnesota doctors Mon, 21 Nov 2022 19:34:44 +0000

On Monday, leading Minnesota pediatricians urged parents to consider alternatives to emergency room visits for mildly ill children during an early and busy flu season that is crowding hospital beds.

While seriously ill children need immediate care – especially those who are dehydrated or have difficulty breathing – doctors have said many patients can be cared for at home.

“Fevers by themselves are not a reason to come to the emergency room unless they’ve been going on for a long time,” said Dr. Andrea Singh, chair of pediatrics for Park Nicollet. “More than four to five days, we probably want to see you.”

Doctors from six competing medical systems held a press conference together Monday to offer a unified voice of caution to Minnesotans amid early and high levels of infections involving RSV and influenza — and still some COVID-19.

Only two of 144 pediatric intensive care beds were available in Minnesota on Nov. 15, a 98% occupancy rate that only happened twice at the peaks of the COVID-19 pandemic, according to the latest update. state day. Only 29 of the 441 general pediatric beds were available at that date. High occupancy rates are forcing more children requiring hospital care to sit in emergency rooms, and more patients requiring emergency care to sit in waiting rooms.

“There were days when 30 to 40 children were waiting in our emergency department for an inpatient bed,” said Dr. Rob Sicoli, medical director of Minnesota Children’s Emergency Services in Minneapolis and St. Paul. “It’s unprecedented. It reinforces care for all other children.”

RSV, short for respiratory syncytial virus, is common in infants every winter, but usually not until December. Conditions have changed amid the COVID-19 pandemic, however, as RSV emerged last summer and fall this year. More than 180 RSV-related hospitalizations were reported among patients in the Twin Cities seven-county metropolitan area during the week ending Nov. 12, according to the state’s weekly respiratory disease report.

The 439 flu-related hospitalizations in Minnesota are also unusually high at this point in late fall, according to the state report. The median age of these hospitalized patients is just 48, below the norm of 50 to 70 and reflecting the rise in infections among children. No influenza-related pediatric deaths have been reported so far.

Doctors toed a fine line in their message on Monday, not wanting to discourage parents from bringing in children in need of hospital care.

Parents should consult their local pediatrician first, said Dr. Ashley Strobel, emergency physician at Hennepin Healthcare in Minneapolis, which hosted the news conference.

But she said parents should bring children who are dehydrated (often presented with dry diapers), who have fevers above 104 degrees for five or more days, or who have so much trouble breathing that their ribs are exposed when they inhale or “their nostrils pop and go in, kind of like that bull you see in cartoons, back in the days of Looney Tunes,” she said.

Finding RSV tests in mild cases is unnecessary – there is no specific treatment for the infection in most cases – and takes up limited capacity in clinics and hospitals, a said Dr. Jill Amsberry, medical director of the cloud-based St. CentraCare Pediatric and Adolescent Clinic.

“We do not need to be tested for RSV to return to daycare or school. If you have no other needs in health care facilities, we simply urge you to stay home. home,” Amsberry said.

Staffing shortages at hospitals — partly due to an exodus of workers amid the COVID-19 pandemic — have contributed to the pressures, as well as rising patient numbers.

Sicoli said the current situation with influenza and RSV resembles a “bad mid-winter” in other years. However, it is unclear whether the early start to the respiratory virus season will result in an extended season or simply an early peak and then a milder winter.

Fears of a severe flu season first emerged around the world in Australia, which saw an early spike in sick children, but it dissipated quickly and did not wreak unusually harsh havoc on children. the elderly. Other parts of the southern hemisphere have not had severe flu seasons.

RSV-related hospitalizations may have already plateaued in Minnesota, but are still creating pressure alongside the sudden increase in flu cases. In addition to deciding whether or not to take children for care, parents can help by reducing illness in the first place, said Dr. Will Nicholson, president of the Minnesota Medical Association and vice president of medical affairs for Metro Hospitals. is from M Health Fairview.

Strategies include staying home when sick, washing hands, getting vaccinated and wearing masks in crowded and high-risk places, he said.

“We need your help. We need you to join our team,” he said. “Right now you can do a lot to stay healthy. We want you to stay healthy.”

Hickory doctor leads Southern Medical Association Sat, 19 Nov 2022 11:00:00 +0000

HICKORY — The Southern Medical Association has announced the installation of Lawrence “Lee” Carter, MD, as president for 2022-23. Dr. Carter was installed during the SMA Annual Scientific Assembly in Pigeon Forge, Tennessee on October 30.

Carter is board certified in internal medicine with over 20 years of experience and in private practice with Adult Internal Medicine in Hickory. He has also been affiliated with the MDVIP for 11 years.

Carter earned his undergraduate degree from the University of North Carolina (UNC) at Pembroke, where he was an All-American college football player. Carter received her medical degree from Bowman Gray School of Medicine at Wake Forest University in Winston-Salem. He completed his residency at Morristown Memorial Hospital, in Morristown, New Jersey. Carter also served in the US Air Force Medical Corps, achieving the rank of major.

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Additionally, Carter conducted seven years of cardiac research in the Department of Anesthesiology at UNC Chapel Hill, publishing numerous articles during that time. He also participated in three medical missions in Costa Rica.

During his tenure as SMA Chair, Carter’s key initiatives will include mentorship, as well as physician and patient empowerment.

“I am honored to serve as President of this wonderful association and with a single mission of education, SMA is poised to provide outlets for collaboration among colleagues and opportunities for healthcare professionals to share their expertise. with each other,” he said. “By engaging with each other, we can work together and learn from each other. In turn, we can help our patients realize their abilities to change and guide them towards a better life.”

An active member of the SMA for nearly 20 years, Carter previously served as an SMA Advisor representing the State of North Carolina, as well as a member of the SMA Membership and Strategic Planning Committees. In addition to his involvement with the SMA, Carter is a member of the American Diabetes Association, North Carolina Medical Society, and Catawba County Medical Society.

Founded in 1906 and based in Birmingham, Alabama, SMA’s mission is to improve the quality of patient care through multidisciplinary and interprofessional education.

AMA Report: Why Medicare Indexing Matters Wed, 16 Nov 2022 23:45:15 +0000

Australian Medical Association President Professor Steve Robson said the AMA analyzed the indexing of the most commonly used Medicare item in general practice, the Level B consultation item, in the report. Why Medicare Indexing Matters published this week.

“Inadequate indexing has put all medical practices under pressure, especially general practices where so many patients have to be mass billed because they cannot afford out-of-pocket charges. What we found clearly illustrates why the state of general practice is so dire; why wholesale billing is under pressure; why patients are increasingly faced with higher out-of-pocket expenses and why so many practices are hitting a financial wall. said Professor Robson.

Starting in July this year, Medicare items were indexed by 1.6% despite practice costs such as salaries, rent and utilities climbing at a much higher rate. The AMA’s analysis of the Level B consultation element (the element used for consultations lasting less than 20 minutes) found that inadequate indexing “saved” the government approximately $8.6 billion. dollars over the life of the item.

“Medicare reimbursement is patient reimbursement, not doctor reimbursement, and therefore reflects what the government is willing to pay for healthcare in Australia,” Prof Robson said.

“Our analysis shows that successive governments have taken healthcare funding away from Australian taxpayers due to poor indexation and shifted the cost of care to ordinary Australians. Doctors either have to absorb the cost and risk becoming unsustainable. , or increase the costs to be borne by patients.This is not a lasting solution.

“The AMA’s Plan to Modernize Medicare campaign is calling on the government to implement a revised escalation tool to ensure reimbursements better reflect the rising costs of delivering high-quality medical care and managing of a doctor’s office.”

The AMA estimates that better indexation across the entire MBS could cost the government $4.98 billion over four years, just over half of what was taken out of one element of the MBS.

Read the AMA report Why Medicare Indexation Matters

The AMA is also continuing the #SicklySweet campaign calling for a sugary drink tax to increase the retail price of an average supermarket sugary drink by 20%. This would lead to a reduction in obesity of around 2% and 16,000 fewer cases of type 2 diabetes in Australia over 25 years, as stated in the AMA research report A Tax on Sugary Drinks: what the modeling shows.

See also AMA’s research report Solutions to Australia’s Chronic Wound Problem and AMA’s Plan to Modernize Medicare Campaign

Canada is experiencing an early rise in flu cases. Is a “tidal wave” of infection coming? Fri, 11 Nov 2022 11:04:02 +0000

Canada is on track to face its first full flu season in several years – a season that is starting earlier than usual, when the country’s health system is already struggling with respiratory infections like COVID-19. and RSV.

It’s unclear how the coming months will unfold, including what level of pressure severe flu infections will put on overwhelmed hospitals, and how this year‘s list of viruses will interact now that SARS-CoV-2 is firmly in the picture. The mixture.

But what is clear is that there is already a sharp rise in recent infections and that a “tidal wave” of cases is likely, said infectious disease physician Dr Sameer Elsayed and medical microbiologist in London, Ont, and professor at Western University.

“We’re going to have a big flu season, I think, this year.”

On a national level, influenza activity “increased sharply” and crossed the seasonal threshold of 5% of samples coming back positive at the end of October. If these trends continue, the federal government will declare the start of an influenza epidemic in Canada in its next update, scheduled for November 14.

Ontario has already surpassed that benchmark, with about 10% of recent tests coming back positive for this year’s dominant strain of influenza A.

In Public Health Ontario’s latest update of November 4the province said the flu season started “more than a month earlier than what is typically seen in pre-pandemic seasons.”

The early start comes as children’s hospitals across the province are already overflowing with children with illnesses such as respiratory syncytial virus, or RSV, and as positive test results for COVID-19 are back on the rise, recently reaching 17%.

“Over the next few months, Ontario will likely face the triple threat of respiratory disease,” said Dr. Rose Zacharias, president of the Ontario Medical Association, an advocacy group for physicians. at a press conference on Wednesday.

Alberta also began to experience a spike in influenza A cases. end of Octoberalongside the circulation of other pathogens, and BC public health officials are also monitoring a continued increase in positive samples.

“Right now we’re seeing the flu spread and samples coming in from long-term care facilities, children’s hospitals and adult hospitals,” said medical microbiologist Dr Linda Hoang, associate director and program head. from the bacteriology and mycology laboratory at the BC Center for Disease Control.

Hints from the southern hemisphere

The progression of the flu season in Canada from here may mirror, to some extent, what countries in the southern hemisphere experienced earlier this year.

In Chile, where the 2022 flu season has passed, influenza A began circulating “months earlier” than during pre-pandemic flu seasons, according to a recent report published by the United States Centers for Disease Control. (The United States is also experiencing an early start, southern states experiencing the highest surges.)

Chilean officials reported more than 1,000 hospitalizations during the season. That’s higher than during the COVID pandemic when public health restrictions and other factors kept the flu at bay for more than a year, but lower than during recent pre-pandemic flu seasons. The country’s flu shots also cut the risk of hospitalization by nearly half.

Data on lab-confirmed flu cases in Australia this year also show that the country has seen both an early start and end to its flu season, and a far higher level of infections than any of the previous five years.

But the clinical severity of the 2022 flu season – referring to the total number of deaths and the proportion of patients admitted to intensive care – has been rated “low” by the Australian government.

WATCH | Ontario doctors warn of a ‘triple threat’ respiratory season:

Concerns grow over triple threat of respiratory disease surge

The Ontario Medical Association is urging people to wear masks indoors and get their flu and COVID-19 shots amid growing concern that a spike in flu cases could overwhelm a system healthcare that is already seeing an influx of RSV and COVID patients.

So what do these trends portend for Canada in the months ahead?

Alyson Kelvin, a virologist and researcher at the Vaccine and Infectious Disease Organization at the University of Saskatchewan, said it’s possible our flu season could also “peak and decline” earlier as well.

But she pointed out that the combination of influenza and other respiratory viruses, including the first circulation of COVID during the winter months without any public health restrictions, makes the period ahead particularly difficult to predict.

It is possible that the early start of the flu season in the southern hemisphere, now spilling over to countries further north, suggests that the virus is moving through circulation on the heels of other waves of infections.

“We could see a further increase in COVID-19 cases, possibly in early January,” Kelvin said. “But it could also just be the aftermath of not having seen the flu in the past two years; I really don’t know. And I’ll be watching the numbers to see a clearer pattern over the next two years.”

Is it time for masks again?

Hospital teams fear that different waves of viral infections could mean months of strain on Canada’s health care system, whether or not flu cases alone account for high levels of hospitalizations this season.

“It’s only November,” Dr. Fahad Razak, an internist at St. Michael’s Hospital in Toronto, said in an interview on CBC News Network.

“Respiratory virus season, including influenza and RSV, but of course COVID as well, is expected to peak in the coming months, so we haven’t seen, probably, how much worse it’s going to get.”

The coming months could be “very, very difficult”, he added, given the already long wait times for access to care in many overwhelmed and understaffed hospitals across the country.

Given these concerns, a growing choir of doctors now call for a back to wearing a mask indoors to mitigate the spread of viral infections.

WATCH | Toronto doctor calls for return of mask mandates:

It’s time to bring back the mask mandate, says a Toronto doctor

Dr. Fahad Razak, an internist at St. Michael’s Hospital, says the triple threat posed by COVID-19, RSV and influenza should be addressed through public health measures like mask mandates.

“If added to the other layers of protection, including vaccination, it could actually make a difference in terms of mitigating the surge so that hospitals can cope a little better,” said the director of the Public Health of Canada, Dr. Theresa Tam. said at a press conference on Thursday.

A study published this week in the New England Journal of Medicine offered more evidence to suggest that masks can help mitigate transmission of the virus. The peer-reviewed research, which focused on Boston school districts, found that lifting masking requirements was associated with about 45 additional COVID cases per 1,000 students and staff in the months after the end. of a statewide policy.

Masks are a blunt and flawed tool, Razak said, but one that has also helped keep the flu at bay in Canada for much of the pandemic.

The 2020 flu season ended abruptly after a series of public health restrictions were put in place to combat COVID, and there was also no evidence of community circulation of the flu the following season.

Generally, the flu is thought to kill thousands Canadians each year, while COVID is currently killing hundreds every week.

Canadians encouraged to get flu and COVID vaccines

Getting a vaccine to protect against both is paramount this fall, several medical experts pointed out in recent interviews with CBC News.

It is even safe to get both a COVID reminder and an annual flu vaccine at the same appointment, according to the National Advisory Committee on Immunization of Canada.

Kelvin, who has long studied the flu, said Canadians should always take the threat of the flu seriously.

The added fear now, she said, is that it comes back while there is another respiratory virus – SARS-CoV-2 – now in the mix.

“It will add to the increase in serious illness cases,” she said. “And that’s what I want to be careful about – that we’re doing everything we can to reduce the transmission of respiratory viruses in the community.”

Pet owners in the United States face a shortage of veterinarians Tue, 08 Nov 2022 16:47:13 +0000

More animals, fewer veterinarians. There is a nationwide shortage of veterinarians that is affecting clinics’ ability to care for our four-legged friends, with longer wait times for appointments and more stress for veterinarians currently on the job market. work.

Data from the American Veterinary Medical Association in 2021 showed that 44% of veterinarians have at some point considered leaving the profession; 39% over the past five years. And nearly 26% said they wanted to work fewer hours, citing reasons including work-life balance, stress, anxiety and burnout.

These reasons prompted Dr. Jackie Kucskar to quit her job in general veterinary practice in 2019, where she found herself trying to fit as many patients as possible into a very stressful environment.

“It was a huge burden on me and my quality of life suffered tremendously. And I felt like I wasn’t the best vet I could be for my patients and for the people who were supporting those patients,” says Kusckar. .

Dr. Kucskar now performs spaying surgeries and cares for pets at the Animal Protective Foundation in the New York Capital Region. “The fact that I can feel like I’m really helping animals every day – that makes me really happy,” says Kucskar.

The turnover rate for veterinarians is higher than that of other medical professions, while the demand for veterinarians is growing. A report by Mars Veterinary Health projects that by 2030, the United States will need nearly forty-one thousand more veterinarians and one hundred and thirty-three thousand certified veterinary technicians to care for American companion animals.

Long Island University’s College of Veterinary Medicine in Brookville, New York, is training the next generation to help fill this gap in the workforce. The school opened during the pandemic and will graduate in 2024. Dr Carmen Fuentealba is the dean and says there is an upside to this shortage. “Many, many job opportunities,” she says, adding that many of her students are already having conversations with potential employers.

Students say they are prepared for the rigors of the profession, including discussions of mental health early in their studies. Third-year student Kelly Locke says the shortage actually gives her and her classmates leverage “to show that what we’re learning and the degrees we have are actually worth what we should be paid and how we should be treated in the industry”.

Earlier this year, two dozen industry leaders called on the AVMA to support increased veterinary college class sizes and additional programs to help alleviate what they call a labor crisis. – “acute and growing” work. Some corporate practices have recently begun offering signing bonuses of up to $100,000 to attract vets to work. Proponents also suggest empowering vet techs to work at the peak of their license to help take some of the pressure off doctors.

Attorney General Bonta Leads 21 States to Urge FDA to Approve Nation’s First Over-the-Counter Birth Control Pill | State of California – Department of Justice Fri, 04 Nov 2022 16:08:20 +0000

If approved, the pill would be available to buy without a prescription, removing barriers to accessing safe and timely reproductive care.

OAKLAND – California Attorney General Rob Bonta today announced the leadership of a multi-state coalition of 21 attorneys general in submitting a letter urging the United States Food and Drug Administration (FDA) to approve birth control pills over-the-counter products that meet applicable safety and efficacy standards. , including a pending request for the country’s first over-the-counter pill. If approved, safe and effective birth control pills will be available for purchase over-the-counter, removing the barriers that currently prevent many people from accessing safe and timely reproductive care. In the letter, the attorneys general argue that approving the pill would give individuals — especially those in vulnerable populations — greater control over their health, lives and futures, and help them avoid the health and economic perils that come with it. unwanted pregnancies.

“California is a proud state of reproductive freedom, and we continue to lead efforts to protect, expand and strengthen access to this freedom nationwide, including supporting efforts to expand access to controlled safe and effective births”, said Attorney General Bonta. “It’s not just about a pill, it’s about empowering people, especially people of color, people from low-income families or rural communities. It’s about breaking down the barriers that imprison them in lives they didn’t choose. Every individual deserves equal access to the reproductive care they need, and I remain committed to the fight to ensure that access.

The FDA is currently reviewing an application to approve a birth control pill, named Opill, for over-the-counter use. If approved, people in need of a contraceptive could, for the very first time, walk into a pharmacy and buy it without a prescription.

In the open letter to the FDA, the attorneys general say the pill should be approved for over-the-counter use because:

  • It has proven to be safe and effective for most users: Studies show that progestin-only pills, like Opill, carry a much lower risk of blood clots than traditional birth control pills that combine estrogen and progestin, because they contain synthetic progestin and no estrogen. And studies of progestin-only birth control pills show that they are over 90% effective in preventing unwanted pregnancies – more effective than methods such as spermicide, condoms or sponges.
  • This would remove barriers to obtaining a contraceptive that many face: Researchers say that one-third of adults in the United States who have ever tried to get prescription contraception said they face difficulties, such as getting an appointment, traveling for visits to the clinic or browsing restrictions on the amount they can buy monthly. Additionally, a third of contraceptive users say they forgot to take their contraceptive because they couldn’t get their next supply on time. An over-the-counter birth control pill would eliminate many of these challenges and reduce the risk of people being forced into unwanted pregnancies due to circumstances beyond their control.
  • It would provide essential assistance to people from vulnerable populations: Barriers to birth control access disproportionately impact people of color, low-income families, and people living in rural areas, who are more often underinsured or uninsured, and therefore have more difficulty getting the reproductive care they need. OTC options would go a long way to reducing these inequalities and making the healthcare system more equitable and accessible to all. The benefits of such a system include lower maternal mortality rates, less poverty, higher levels of physical and mental health, and more economic freedom and opportunity for vulnerable communities.

In the letter, the attorneys general point out that the approval of an over-the-counter birth control pill is supported by the medical community. Three major medical organizations in the United States – the American College of Obstetricians and Gynecologists, the American Medical Association, and the American Academy of Family Physicians – support the availability of contraceptives without a prescription. In addition, birth control pills are already available over the counter in about 100 countries, including Mexico.

The attorneys general also say that following the U.S. Supreme Court’s decision to overturn Roe vs. Wade earlier this year, many states banned or restricted abortion care, narrowing choices for those seeking reproductive care and making access to birth control even more critical nationwide, including for Californians who can travel, live, work or study in anti-abortion states.

Supporting, expanding and protecting reproductive freedoms is a top priority for Attorney General Bonta: In October, the Attorney General launched the California Reproductive Rights Task Force, bringing together legal and law enforcement partners to protect reproductive rights in the state and published a newsletter. California law enforcement to approach out-of-state agencies that may seek to investigate, arrest, or prosecute foreign patients seeking reproductive care in the state. He also led 23 attorneys general across the country in filing a letter supporting the U.S. Department of Veterans Affairs’ new rule establishing broader access to abortion care for veterans and their beneficiaries. In September, the attorney general led a multistate coalition of 21 attorneys general in an amicus brief supporting a motion by reproductive rights advocates seeking to end enforcement of several Texas anti-abortion laws, launched a consumer alert to help Californians protect their privacy while accessing procreation. or abortion care, and issued legal guidance on prohibiting extradition of individuals providing or accessing reproductive care in California. In June, it issued guidelines on abortion rights and protections under California law, which remain fully intact, following the U.S. Supreme Court’s decision to overturn Roe vs. Wade. It also issued a California consumer alert warning Californians seeking reproductive health services of the limited and potentially misleading nature of services provided by Crisis Pregnancy Centers, and outlined health app obligations under California law to protect and secure reproductive health information.

In filing the open letter, Attorney General Bonta is joined by the attorneys general of Colorado, Connecticut, Hawaii, Illinois, Iowa, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, North Carolina, Oregon, Pennsylvania, Rhode Island, Vermont and Washington.

A copy of the letter is available here.

Australia’s Labor budget deals a triple blow to public hospitals Sat, 29 Oct 2022 04:20:33 +0000

Despite a resurgence of the COVID-19 pandemic, the Albanian government’s first budget, presented on Tuesday, contains a devastating cut to the country’s already overstretched and underfunded public hospitals.

Budget documents reveal that payments to states and territories for public hospitals are set to decline by more than $755 million this fiscal year and $2.4 billion over four years.

Australia’s Labor government budget drastically cuts health funding. [Photo: Australian National Audit Office]

The devastating impact of this cut on beleaguered public hospitals, overworked healthcare staff and often critically ill patients will be compounded by two other budget decisions. The first is to end the federal government’s 50% contribution to hospital budgets during the pandemic, reducing its share to 45% by December 31.

The other is to simultaneously reimpose a 6.5% annual cap on federal hospital funding. This is under conditions where the official inflation rate has just reached 7.3% and is now expected to exceed 8% by the end of the year.

The costs of medical services (“medical inflation”) are rising even faster. Earlier this year, the Victorian Healthcare Association revealed that inflation would cut that state’s healthcare budget by more than 13% in real terms this financial year, leaving doctors warning of worse patient outcomes at a record time of demand.

Australian governments have imposed a profit-driven ‘let it rip’ COVID regime on the people, resulting in more than 13,000 deaths this year, at least ten million infections and hundreds of thousands facing the prospect of death. a long debilitating COVID and other life-threatening ones. -long medical conditions.

Now, led by the federal Labor government, they are stepping up the assault on the public health system, defying strikes and protests by nurses and other health care workers over intolerable workloads, low wages and wage cuts real.

The crisis ravaging public hospitals will intensify, with beds at full capacity, ambulances crawling past emergency departments, patients waiting years for essential elective surgery and health workers suffering from extreme stress, d burnout and burnout.

This is one of the deepest attacks on working class living and social conditions contained in the Labor Party budget, in addition to soaring prices for electricity, gas, gasoline and food, soaring interest rates and mortgage repayments, at least two more years of real wage cuts and about 150,000 job losses over the same period.

Public hospitals were severely underfunded long before the pandemic, but the COVID disaster has taken the breakdown to a new level. There is mounting evidence that the next wave of infections, hospitalizations and deaths has begun, fueled by the novel coronavirus mutations that capitalist governments have allowed to proliferate around the world.