Alpha Omega Alpha Honor Medical Society SPRING 2017
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Alpha Omega Alpha Honor Medical Society SPRING 2017 THE PHAROS of Alpha Omega Alpha honor medical society SPRING 2017 Alpha Omega Alpha Honor Medical Society “Be Worthy to Serve the Suffering” Founded by William W. Root in 1902 Editor Richard L. Byyny, MD Officers and Directors at Large Joseph W. Stubbs, MD, MACP President Managing Editor Dee Martinez Albany, Georgia Eve Higginbotham, SM, MD Art Director and Illustrator Jim M’Guinness President-Elect Philadelphia, Pennsylvania Designer Erica Aitken Robert G. Atnip, MD, FACS, RPVI Immediate Past President Hershey, Pennsylvania Wiley Souba, Jr., MD, DSc, MBA Editorial Board Secretary-Treasurer Hanover, New Hampshire Holly J. Humphrey, MD Jeremiah A. Barondess, MD James G. Gamble, MD, PhD C. Ronald Mackenzie, MD Chicago, Illinois New York, New York Stanford, California New York, New York Richard B. Gunderman, MD, PhD David A. Bennahum, MD Michael Gerber, MD Philip A. Mackowiak, MD Indianapolis, Indiana Albuquerque, New Mexico Denver, Colorado Baltimore, Maryland Sheryl Pfeil, MD John A. Benson, Jr., MD Dean G. Gianakos, MD Ashley Mann, MD Columbus, Ohio Portland, Oregon Lynchburg, Virginia Kansas City, Kansas Alan G. Robinson, MD Richard Bronson, MD Jean D. Gray, MD J. Joseph Marr, MD Stony Brook, New York Halifax, Nova Scotia Broomfeld, Colorado Los Angeles, California John C.M. Brust, MD Richard B. Gunderman, MD, PhD Aaron McGuffn, MD John Tooker, MD, MBA New York, New York Indianapolis, Indiana Huntington, West Virginia Philadelphia, Pennsylvania Charles S. Bryan, MD Lara Hazelton, MD Stephen J. McPhee, MD Steven A. Wartman, MD, PhD Columbia, South Carolina Halifax, Nova Scotia San Francisco, California Washington, DC Robert A. Chase, MD David B. Hellmann, MD Janice Townley Moore Peterborough, New Hampshire Baltimore, Maryland Young Harris, Georgia Medical Organization Director Griffin P. Rodgers, MD, MBA Lynn M. Cleary, MD Pascal J. Imperatos, MD, MPH&TM Francis A. Neelon, MD Syacuse, New York Brooklyn, NY Durham, North Carolina National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health Fredric L. Coe, MD Therese Jones, PhD Douglas S. Paauw, MD, MACP Bethesda, Maryland Chicago, Illinois Aurora, Colorado Seattle, Washington Jack Coulehan, MD John A. Kastor, MD John S. Sergent, MD Councilor Directors Stony Brook, New York Baltimore, Maryland Nashville, Tennessee Regina Gandour-Edwards, MD Gregory Davis, MD Henry Langhorne, MD Jan van Eys, PhD, MD University of California Davis School of Lexington, Kentucky Pensacola, Florida Nashville, Tennessee Medicine Lawrence L. Faltz, MD Jenna Le, MD Abraham Verghese, MD, DSc Charles Griffith III, MD, MSPH Larchmont, New York New York, New York (Hon.) University of Kentucky College of Medicine Joseph J. Fins, MD Michael D. Lockshin, MD Stanford, California New York, New York New York, New York Steven A. Wartman, MD, PhD Kahtleen F. Ryan, MD Drexel University School of Medicine Faith T. Fitzgerald, MD Jerome Lowenstein, MD Washington, DC Sacramento, California New York, New York Gerald Weissmann, MD Coordinator, Residency Initiatives Lester D. Friedman, PhD Kenneth M. Ludmerer, MD New York, New York Geneva, New York Suzann Pershing, MD St. Louis, Missouri Stanford University Student Directors www.alphaomegaalpha.org Jeremy T. Bolin Uniformed Services University of the Health Sciences F. Edward Hébert School of Medicine Manuscripts being prepared for The Pharos should be typed double-spaced and conform to the format outlined Richard Latuska, MD in the manuscript submission guidelines appearing on our website: www.alphaomegaalpha.org/contributors.html. Vanderbilt University School of Medicine Editorial material should be sent to Richard L. Byyny, MD, Editor, The Pharos, 525 Middlefield Road, Suite 130, Sean Christensen, MSIV Menlo Park, California 94025. E-mail: [email protected]. University of South Carolina School of Medicine Requests for reprints of individual articles should be forwarded directly to the authors. The Pharos of Alpha Omega Alpha Honor Medical Society (ISSN 0031-7179) is published quarterly by Alpha Omega Alpha Honor Medical Society, 525 Middlefield Road, Suite 130, Menlo Park, California 94025, and printed Administrative Office by The Ovid Bell Press, Inc., Fulton, Missouri 65251. Periodicals postage paid at the post office at Menlo Park, Richard L. Byyny, MD California, and at additional mailing offices. Copyright © 2017, by Alpha Omega Alpha Honor Medical Society. Executive Director The contents of The Pharos can only be reproduced with the written permission of the editor or managing editor. Menlo Park, California (ISSN 0031-7179). 525 Middlefeld Road, Suite 130 Circulation information: The Pharos is sent to all dues-paying members of Alpha Omega Alpha at no additional Menlo Park, California 94025 cost. All correspondence relating to circulation should be directed to Ms. Dee Martinez, 525 Middlefield Road, Telephone: (650) 329-0291 Suite 130, Menlo Park, California 94025. E-mail: [email protected]. Fax: (650) 329-1618 POSTMASTER: Change service requested: Alpha Omega Alpha Honor Medical Society, 525 Middlefield E-mail: [email protected] Road, Suite 130, Menlo Park, CA 94025. 2 Editorial I Health care in America: A right or privilege? John Tooker, MD, MBA, MACP; introduction by Richard L. Byyny, MD, FACP 9 Seeing the eye doctor Douglas H. Forsyth, MD 10 Primum non nocere: Daniel Patrick Moynihan and the defense of academic medicine Joseph J. Fins, MD, MACP; Joan M. Leiman, PhD; and Herbert Pardes, MD 21 The genomic revolution and its implications for medical practice William B. Neaves, PhD 28 Memory Katharine Lawrence, MD, MPH 30 A Victorian New Woman Amy L. Whalen, MD; Mary E. Groll, MD, MS; Ronald H. Sims 37 Small, medium, and large: Growth abnormalities of the mandible Morton H. Goldberg, DMD, MD 40 Pan Am Professor Nicoline Schiess, MD, MPH 2017 47 A doctor’s doctor Bonnie Prokesch, MD Spring 50 Medicine on the big and small screen • Les Friedman, PhD, and Therese Jones, PhD, Movie Review Editors 2 52 Letters to the Editor 54 Reviews and reflections Number 80 62 2016 Honor Roll of Donors Volume • 80 Chapter and national news: AΩA to move national office to Colorado Science and Technology Park at Fitzsimons Life Science District in Colorado Cover Illustration by Jim M’Guinness The Pharos The IN THIS ISSUE THIS IN Health care in America: A right or a privilege? John Tooker, MD, MBA, MACP; introduction by Richard L. Byyny, MD, FACP remedies—was more about public health than individual Dr. Tooker (AΩA, University of Colorado, 1970) served as patients, and was considered more effective than care by Chief Executive Officer and Executive Vice President of the doctor. While doctors could diagnose some illnesses, the American College of Physicians from 2002 – 2010. there were primarily mystical treatments with potions that In that capacity he was involved in developing the policy did nothing, or could cause further harm. framework of the Affordable Care Act. He is a member Health care was inexpensive, with the average American of the AΩA Board of Directors. spending about 5 per year on health care. Physician payment was often a bartering system of reciprocal exchange of goods or services, or direct financial payment. Introduction Hospitals were largely places to die, or be isolated from by Richard L. Byyny, MD others, with some surgeries performed using rudimentary anesthesia. Most medical care, births, and surgeries were performed in the home. Every gun that is made, every warship launched, every Health insurance evolved during the industrial devel- rocket fired, signifies in the final sense a theft from those opment, that followed the Civil War. Most industrial jobs who hunger and are not fed, those who are cold and are were dangerous and associated with job-related injuries not clothed. that often resulted in life-long disabilities. In some indus- tries, more than 10 percent of workers were injured, or —President Dwight D. Eisenhower killed, on the job. Many companies employed doctors and nurses, and provided on-site clinics and infirmaries with Those who are sick and cannot get care could be added care provided, and paid for, by the company. Businesses to the above statement by Pres. Eisenhower. Thirty-two had a stake in the health and well-being of their employees. of the 33 developed countries in the world have universal Unions gradually became influential, resulting in factory health care. These countries have concluded that health workers and others being provided industrial sickness care for all is a moral right. The one developed country in funds for accidents and illness. the world that has not resolved that health care is a funda- In 1910, Montgomery Ward developed the first multi- mental human right is the United States of America. employee health insurance policy to cover work related The evolution of the U.S. health care system empha- disability. There was a movement toward compulsory sick- sizes individual responsibility, free choice, and pluralism. ness coverage, but businesses thought it was too expensive This results in a system where health care is a privilege and viewed it as the equivalent of a pay raise for employees. paid for by the individual through employer health insur- Doctors were concerned that health insurers would control ance; by government socialized insurance (Medicare and payment and practice. Medicaid); by the military; through Congressional insur- During the depressions of 1914 and 1929, people who ance (for members of Congress only); through the Veterans were out of work didn’t have access to health care (no job, Administration; or by Indian Health Service. no company care), and because they were out of work they In the U. S. health care system—a capitalist system— couldn’t afford to pay the local doctor through bartering or health care is considered an economic good where patients with cash. Hospitals were being built, but had few patients are analogous to commodities, and services are provided as they could not pay for care. To help their local hospital based primarily on an individual’s purchasing power.