medical schools

Survey says: Hospitals not treating pain sufficiently

Anne Zieger — Fri, 31 Oct 2008 11:08:37 -0400

Hospitals are not treating pain as well as they could, says a new survey out today from the New England Journal of Medicine. The survey, which was done in hospitals from 40 major metropolitan areas, showed that nearly one-third of patients felt that their pain relief was not sufficient. Yet modern medicine can relieve nearly all pain.

What are the reasons for this discrepancy? For one, in spite of 76 million Americans living in chronic pain, medical schools give only a one hour training session on understanding and dealing with pain in their patients. Further, there are very few pain specialists even though pain management is a widespread problem.

And even though an estimated three-quarters of people over the age of 65 suffer from chronic pain, only 2 percent of NIH funds go toward pain research.

To learn more about the survey results:
- read this McClatchy-Tribune piece

Medtronic to disclose gifts to healthcare groups

Anne Zieger — Mon, 15 Sep 2008 11:19:30 -0400

Perhaps going with the prevailing winds--which definitely favor disclosing gifts to healthcare players before the state makes you do it--medical devicemaker Medtronic has decided to voluntarily disclose the financial support it offers to various healthcare groups, including professional organizations, healthcare-advocacy groups, medical schools and hospitals. Each quarter, Medtronic will disclose how it supports various activities conducted by the groups, including continuing medical education events, consumer education, hospital grand rounds presentations and scholarships.

The move already has its critics, who say that Medtronic's approach to disclosure doesn't do enough to explain how their financial gifts are used. For example, Medtronic funded CME seminars held by the American College of Osteopathic Family Physicians, orthopedic grand rounds at Baylor College of Medicine and cardiology grand rounds at Boston Medical Center. These critics would like to know if, for example, the gifts were used to fly in a company speaker to pitch at a given event.

To learn more about this new policy:
- read this Modern Healthcare piece

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Mannequins help doctors practice their moves

Anne Zieger — Thu, 04 Sep 2008 12:17:34 -0400

Sometimes, when medical schools want to teach students the basics--or senior faculty some new tricks--they hire live people to come in and play the role of a patient with one disorder or another. Sometimes, however, you don't have to actually be alive to help doctors refine their skills. At the Simulation Learning Center at Oak Lawn, IL-based Advocate Christ Medical Center, the patients are mannequins, even if the doctors are the real thing. These mannequins have computerized heart rates, pulses and even voices that can make diagnostically-relevant noises. Article

Study: Women scarce in neurosurgery

Anne Zieger — Thu, 14 Aug 2008 10:30:44 -0400

Though half of all students enrolled in U.S. medical schools are female, things look much different for the field of neurosurgery, according to a new research report. At present, female board-certified neurosurgeons account for less than 6 percent of the 3,000-odd neurosurgeons practicing now, and fewer than 5 percent of neurosurgeons in private practice are female. Meanwhile, only 300 women, or 2 percent of 16,000 graduating medical students, applied for 180 available residency positions each year over the last decade. If this trend continues, it could lead to a shortage of neurosurgeons as a whole, given the growing role of women in medicine, according to the authors of the study, which appears in the Journal of Neurosurgery.

To address this problem, medical schools and teaching hospitals need more women as department heads and leaders of other functions to help provide younger women with role models, the authors suggest. Right now, only 6 percent of full-time neurological faculty members are female.

To learn more about the study:
- read this Chicago Tribune article

NYC hospitals board member resigns over Caribbean residency deal

Anne Zieger — Fri, 08 Aug 2008 12:11:10 -0400

A board member of New York City's Health and Hospitals Corp. has resigned in the wake of a controversy over his role in bringing in a 10-year, $100 million contract for a Caribbean medical school where he has a paid position. The agency and the board member, Dr. Daniel Ricciardi, have faced withering criticism from officials of the city's medical schools for his part in getting the contract for the city's 11 public hospitals to provide clinical training to students from St. George's University School of Medicine in Grenada.

Dr. Ricciardi, a longtime faculty member and dean of clinical studies of the school, proposed the deal, but said he had recused himself from deliberations. Under its terms, St. Georgi's agreed to pay $400 to $425 a week per student for the city's public hospitals to give its students clinical training. The contract provides training for up to 600 students a year for 10 years. Furious execs with the city's medical schools, meanwhile, argued that this system would force them to pay for clerkships, too--training that has traditionally been free--and possibly raise their tuition rates.

To learn more about the dispute:
- read this New York Times piece

Related Article:
In controversial deal, New York signs Caribbean med school for training

In controversial deal, New York signs Caribbean med school for training

Anne Zieger — Wed, 06 Aug 2008 10:50:00 -0400

Amid a storm of protest, New York City's Health and Hospitals Corp. has signed a 10-year, $100 million deal with a Caribbean medical school to provide clinical training for students at the city's 11 public hospitals. The deal, backed by a HHC board member who works for the school, has met loud complaints from NYC-based medical schools, who say that they're reluctant to compete with demand for such students. The competition will be boosted by the fact that public hospitals in the city will collect more money for every student affiliated with St. George's University School of Medicine, a for-profit school based on the island of Grenada. Meanwhile, critics say that it's not a good idea to bestow the city's prestige on a school whose curriculum, they contend, is more vocational than academic.

Traditionally, med schools have sent third- and fourth-year students into city hospitals to work alongside doctors. The med schools haven't charged for the assistance, though HHC said some institutions have begun paying a flat $250,000 per year. These free clerkships have been a core part of medical education, offering 3,700 rotations for U.S. medical schools at the city's public hospitals. But under the new contract, signed last year, St. George's pays the hospitals $425 to $500 per student per week, along with an annual fee of $50,000 for hospitals taking 24 or more St. George's students.

To learn more about the city's new med school deal:
- read this New York Times article

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College group urges ban on drug, devicemaker freebies

Mon, 28 Apr 2008 06:59:58 -0400

The association representing U.S. medical colleges has come out with a proposed ban on pharma and device-maker gifts on medical college campuses. The group, the Association of American Medical Colleges, would like to prevent drug and medical device companies from handing out free food, gifts, travel and ghost-writing services on these campuses, not only to doctors, but also to staff members and students. To protect patients who need free samples, it's recommending that medical schools set up centralized systems for accepting the samples.

The group also thinks med schools should discourage their faculty from participating in industry-funded speaker's bureaus, under which doctors get paid to promote the benefits of key drugs and devices. While any of the nation's 129 medical colleges would be free to ignore the proposal, most are likely to follow its lead, observers say.

To learn more about the proposal:
- read this article in The New York Times

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Trend: Lack of surgeons squeezes hospitals

Tue, 26 Feb 2008 06:59:54 -0500

In previous decades, medical schools put a cap on student enrollment, believing that controls imposed by managed care plans would reduce demand for physicians. Instead, what's happened is that such limitations have created a mushrooming physician shortage, particularly among primary care doctors and surgeons. While pay climbs rapidly over the first five years of practice, surgeons make less than other specialties in their first year, about $165,000--a big number by non-medical standards, but not huge for young physicians with $150,000 to $250,000 in educational debt.

The lack of surgeons is a particular problem for 54 million Americans who live in rural areas, where these specialists are retiring or leaving the community far more quickly than they can be replaced. Right now, only 9,334 of 211,908 physicians serving rural America are general surgeons, according to AMA data. To address these gaps, medical groups are recommending that schools expand the approximately 1,000 spots a year available for surgical training. They're also suggesting that medical schools look for students who want to practice in rural areas, rather than other standard qualifications such as their clinical research history.

To find out more about this trend:
- read this USA Today piece

Study: Med school pharma limits affect attitudes

Tue, 04 Dec 2007 06:59:55 -0500

Of late, academic medical centers have been instituting tough limits on pharmaceutical companies' relationship with their faculty and staff. On their face, the policies seem to be aimed primarily at insulating working physicians from pressure to buy new, costly drugs. However, it seems that such policies have a secondary effect as well. A new study published in the journal Pediatrics suggests that when medical schools and teaching hospitals limit on pharma access to med students and residents, the students and residents end up with different attitudes about pharma interaction than their peers.

The study, which reviewed 12 other studies published over the past 16 years, found that imposing even minimal limits tended to produce doctors who were more skeptical about product information coming from drug reps. Requiring even a single hour of pharma-related training had a measurable effect on doctor-pharma relationships as well. Not surprisingly, however, the effect of imposing pharma limits was greatest when med schools banned all contact between students and residents.

To learn more about the study:
- read this Modern Healthcare article

Related Articles:
Doctors weigh in on pros and cons of accepting drug/device freebies. Letters
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Groups plan to fight for limits on pharma-doctor ties. Report
UC Davis mulls pharma freebies ban. Report
Henry Ford bans pharma perks, vendor drop-ins. Report
MDs debate whether accepting giveaways is unethical. Editorial
UConn considers pharma gift ban. Report

Trend: Residency programs not keeping pace

Mon, 29 Oct 2007 07:59:56 -0400

While enrollment is climbing rapidly at U.S. medical schools, it's beginning to look like the country's residency programs aren't yet ready to absorb the influx. The nation's 126 medical schools have been taking on more students in response to a call from the Association of American Medical Colleges, which has asked the schools to increase class size almost one-third by 2015. Enrollment across the schools is already up 8 percent since 2002. However, it's proving difficult to step up the growth in the number of residency positions available to these students, since most programs rely largely on Medicare-related funding, which has not grown in recent years.

To address the residency capacity issue, some states are shelling out cash. Texas, for example, contributed $63 million for residency programs this year, more than twice the $25 million it appropriated last year. States are also seeking nongovernmental funding to expand residency programs.

To learn more about this trend:
- read this Houston Chronicle article

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