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The Struggle To Retain Physicians

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Some states are finding it tough to retain physicians. Take Virginia for instance:

A recent study found Virginia retains only 35 percent of its medical school graduates and ranks 31st among other states in retaining doctors.

In 2008, Virginia spent more than $50 million from the general fund to support medical education and had nearly 600 new physicians graduate from Virginia’s four medical schools.

Despite this, Virginia still struggles to retain medical graduates, with less than 25 percent of Virginia’s physicians graduating from medical schools in the Commonwealth.

Some feel incentives might work:

Dr. Greenawald says other states including North Carolina have incentives to keep medical students in state. He hopes Virginia considers following suit. Dr. Greenawald also said the over burden of paperwork and insurance company oversight have taken doctors away from what they love doing which is providing care to patients. He said that’s prompted many doctors to retire early.

I’m not so sure. Until more medical students feel primary care is worth the effort, the mass exodus to specialties (and the out-of-state training that is often required) will continue.

-WesMusings of a cardiologist and cardiac electrophysiologist.

*This blog post was originally published at Dr. Wes*

American Cancer Society Debunks Prostate Cancer Screening Myths

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Dr. Otis Brawley has taken the gloves off on prostate cancer screening.

Brawley, chief medical officer of the American Cancer Society (ACS), makes some powerful statements about controversies in prostate cancer screening in a new YouTube video that is billed as the first of a series that the ACS will post on discussions with its officials.

Key nuggets from this video — not surprising to anyone who has followed this debate or Brawley’s past comments — include these quotes:

I’m very concerned. There’s a lot of publicity out there – some of it by people who want to make money by recruiting patients – that oversimplifies this – that says that ‘prostate cancer screening clearly saves lives.’ That is a lie. We don’t know that for sure…

…We’re very concerned about a number of clinics that are offering mass screening where informed decision making – where a man gets told the truth about screening and is allowed without pressure to make a decision – that’s not happening. Many of these free screening things, by the way, are designed more to get patients for hospitals and clinics and doctors than they are to benefit the patients. That’s a huge ethical issue that needs to be addressed.

We’re not against prostate cancer screening. We’re against a man being duped and deceived into getting prostate cancer screening.” 

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

ADHD: Is It Genetic?

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British scientists announced that attention-deficit/hyperactivity disorder (ADHD) has been linked to deleted or duplicated DNA segments (copy number variants), which leads to developmental difference in the brains of children with the condition.

Researchers scanned genomes of 366 children with ADHD and compared them with 1,047 unrelated, ethnically matched control subjects. They reported full results in The Lancet.

Rare copy number variants were almost twice as common in children with ADHD compared to the other children. Researchers commented to Reuters that there was a significant overlap between copy number variants found in ADHD and elements of the genome linked to autism and schizophrenia, specifically in a region on chromosome 16.

*This blog post was originally published at ACP Internist*

Wheelchair Control Via iPhone

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Dynamic Controls out of Christchurch, New Zealand, has developed a system by which wheelchair users can control their iPhone using the chair’s own joystick.

Additionally, the iPhone can display important information about the wheelchair, such as the battery charge state, speed, seat adjustment, and heading direction.

All this is communicated via Bluetooth between the iPhone and the wheelchair. The new version of the iPortal system will be unveiled at Rehacare 2010 in Dusseldorf, Germany, next month.

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*This blog post was originally published at Medgadget*

Eat More Calcium To Prevent Calcium-Containing Kidney Stones?

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Over the years I have had a number of patients with painful kidney stones and once they have passed (or been removed) I have felt at a loss to helping them prevent them. “Stay hydrated” somehow didn’t seem adequate, although we know fluid intake can help stave off recurrent kidney stone attacks.

Some textbooks said “avoid calcium” since most stones are made of calcium oxylate. High oxylate levels can be found in some fruits and vegetables, as well as in nuts and chocolate. Yet there was no real scientific evidence that these foods caused stones. The evidence for who got kidney stones was all over the ballpark and for a physician, that means no prevention advice is really proven.

A new study published in the Clinical Journal of the American Society of Nephrology says that calcium rich foods such as low-fat milk and yogurt can be protective. What? Eat more calcium to prevent calcium-containing stones? It seems that higher intakes of calcium are actually associated with a reduction in kidney stone risk. Read more »

*This blog post was originally published at EverythingHealth*

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

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