health insurance in new mexico

Dr. Buttery's Public Health BLOG

• Accreditation council says medical education needs to be revamped.
  

  Modern Healthcare reports that "medical education training needs to move into the 21st century by focusing more on clinical outcomes and other quality measures along with information technology adoption, representatives from the academic medical community told the Medicare Payment Advisory Commission." According to Thomas Nasca, chief executive officer of the Accreditation Council for Graduate Medical Education, "The current system rates a 'C' in terms of its proficiency in training physicians." Comment: A new system should also focus on those conditions that epidemiology show are most common, rather than most rare.

• An estimate of the global prevalence and incidence of herpes simplex virus type 2 infection.
  

  According to the WHO, the total number of people aged 15–49 years who were living with HSV-2 infection worldwide in 2003 is estimated to be 536 million, while the total number of people who were newly infected with HSV-2 in 2003 is estimated to be 23.6 million. While the estimates are limited by poor availability of data, general trends are evident. For example, more women than men were infected, and the number infected increased with age. Although prevalence varied substantially by region, predicted prevalence was mostly higher in developing regions than developed regions.

• Dietary Supplements No Better Than Placebo In Slowing Cartilage Loss In Knees Of Osteoarthritis Patients
  

  In a two-year multicenter study led by University of Utah doctors, the dietary supplements glucosamine and chondroitin sulfate performed no better than placebo in slowing the rate of cartilage loss in the knees of osteoarthritis patients. This was an ancillary study concurrently conducted on a subset of the patients who were enrolled in the prospective, randomized GAIT (Glucosamine/chondroitin Arthritis Intervention Trial). The primary objective of this ancillary study was to investigate whether these dietary supplements could diminish the structural damage of osteoarthritis. The results, published in the October issue of Arthritis & Rheumatism, show none of the agents had a clinically significant effect on slowing the rate of joint space width loss -the distance between the ends of joint bones as shown by X-ray. Comment: One more product highly touted by the vitamin industry shows little effect when studied properly.

• Primary-care medicine said to be facing a crisis.
  

  The New York Times reports, "There is a crisis in medicine today, and it will not be fixed by any candidate's proposal to provide health insurance for the 45 million Americans now without it. In fact, an increase in insured Americans could make it worse." This "crisis is a diminishing supply of primary-care physicians, the doctors on the firing line -- family physicians, internists, pediatricians, gerontologists, and others -- who practice the art and the science of medicine, and who seek to put patients at least on a par with their pocketbooks." These physicians "spend far more time talking to patients and helping them avert health crises, or cope with ailments that are chronic and incurable than they spend performing tests and procedures." In addition, they "ask pertinent questions about health and also about life circumstances," and they "listen carefully to how patients answer." But, many primary-care physicians "are burdened with paperwork and hours spent negotiating treatment options with insurers. And the payments they receive for services have not increased as the costs of running a modern medical practice have risen."
  Comment: Finally a major newspaper has seen through the fallacy of the suggested fixes for the health care system. Just pumping more money in without changing the infrastructure will only make matters worse. Not only are PC Physicians burdened by the insurance bureaucracy but they are woefully underrepresented among medical school graduates. The AMA makes much ado about the health care system but will not pressure medical schools to enhance training in primary care, nor Congress to enhance support for primary care because it is a captive of hospital based specialists..
  

• American Kids Most Medicated
  

  ScienceDaily (Sep. 25, 2008) — American children are approximately three times more likely to be prescribed psychotropic medication than children in Europe. A new study claims that the differences may be accounted for by regulatory practices and cultural beliefs about the role of medication in emotional and behavioral problems. A team of researchers from the USA, Germany and the Netherlands who investigated prescription levels in the three countries said, "Antidepressant and stimulant prevalence were three or more times greater in the US than in the Netherlands and Germany, while antipsychotic prevalence was 1.5 to 2.2 times greater". One of the study authors concluded that, "Direct to consumer drug advertising, which is common in the US, is also likely to account for some of the differences. The increased use of medication in the US also reflects the individualist and activist therapeutic mentality of US medical culture".

• Black Americans Are At Greater Risk for Colon Polyps
  

  New research published in the Sept. 24 issue of JAMA reinforces importance of Black Americans getting screened. Black Americans have a higher occurrence of colon polyps, according to a new study. This is a significant finding considering the incidence of colon cancer among black men has increased and remained unchanged among black women during the last 20 years.
  “These data show that Blacks who receive screening are more likely to have serious polyps, compared to Whites, and are therefore likely to benefit from more intensive screening. Black men and women age 50 years and older should be strongly encouraged to receive colon cancer screening,” said Lieberman, who also is co-director of the OHSU Digestive Health Center at the Center for Health & Healing and a member of the OHSU Cancer Institute. According to the researchers, colorectal cancer prevalence and death are higher among black patients. Death rates for black men and women are 38 percent to 43 percent higher than for white men and women, and incidence rates are 15.5 percent to 23 percent higher in black individuals.
  

• Virtual Colonoscopy As Good as the Conventional Kind, Study Says
  

  CT colonography (CTC), known as virtual colonoscopy, is as accurate at screening for colorectal cancers and pre-cancerous polyps as conventional colonoscopy, the current screening standard, according to the National CT Colonography Trial, a nationwide multicenter study that included the San Francisco VA Medical Center (SFVAMC). "This is a landmark study," says study co-author Dr. Judy Yee, chief of radiology at SFVAMC and professor and vice-chair of radiology at the University of California, San Francisco. "It demonstrates that CTC is a practical alternative to other, more invasive methods of colon cancer screening. The hope is that these results will encourage more health care payers to cover screening CT colonography." The study appears in the September 18, 2008 issue of the New England Journal of Medicine.

• Behavioral Intervention Works To Reduce Risky Behavior
  

  UCSD — In an effort to curb the rising rates of HIV and sexually transmitted infections (STIs) along the Mexico-US border, a binational team of researchers led by the University of California, San Diego School of Medicine have shown that brief but personalized behavioral counseling significantly reduced rates and improved condom use among female sex workers in Tijuana and Ciudad Juarez, Mexico. The researchers observed a 40 percent decline in the combined rate of new STIs (including HIV, syphilis, gonorrhea and Chlamydia) in the group of female sex workers who received the 30-minute one-on-one counseling intervention.

• New cancer-screening strategy uses the immune system to signal early signs of disease
  

  SEATTLE A team of researchers led by Fred Hutchinson Cancer Research Center reports online toda: y in the Journal of Clinical Oncology the validation of a potential "HIV-test" equivalent for the early detection o